Contents |
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Purpose
Record Pathology information when required by the protocol.
Pathology eCRF
Field Name | Description / Instructions | Format |
---|---|---|
Surgical Pathology# | Entere the pathology Number | 20 character |
Surgery Date | Enter the date of the surgical procedure. | DD-MMM-YYYY |
Pathology Resoults Date | Entere the pathology results date | DD-MMM-YYYY |
Specify Other Procedure |
| 100 characters |
Body Site of Collection |
| Use Pick List |
Pathology eCRF - GROSS DESCRIPTION
Field Name | Description / Instructions | Format |
---|---|---|
Pathology Sample Type | Slect the Pathology Sample Type | Use Picl List |
Differentiation |
| Use Picl List |
Condition of Margin |
| Use Picl List |
Number of Lymph Nodes Sampled |
| Use Pick List |
Number of Positive Lumph Nodes | Enter number of positive nodes | Nubmer (3) |
Findings | Enter findings | 24 characters |
Greatest Dimension of Specimen (cm) |
| Number (6,2) |
Second Greatest Dimension of Specimen (cm) |
| Number (6,2) |
Stage of Disease | Enter Statge of Disease | Use Pick List |
Disease T Stage | Select the stage of disease | Use Pick List |
Disease N Stage | Select the stage of disease | Use Pick List |
Disease M Stage | Select the stage of disease | Use Pick List |
Histologic Grade | Enter the grade of histology | 10 characters |
Pathology eCRF - HISTOLOGY
Field Name | Description / Instructions | Format |
---|---|---|
Peritoneal Lavage Result |
| Use Pick List |
Lymphatic Invasion Present |
| Use Pick List |
Vascular Invasion Present |
| Use Pick List |
Microcalcification Present |
| Use Pick List |
Notable Benign Changes |
| Use Pick List |
If Yes, Description (Specify ) |
| 200 characters |
Pathology eCRF - MICROSCOPIC DESCRIPTION
Field Name | Description / Instructions | Format |
---|---|---|
Is this patient evalauable for immunostaining (IHC) | Yes | Use Pick List |
Tumor Marker |
| Use Pick List |
Analyzed | Yes | Use Pick List |
Assay Date |
| DD-MMM-YYYY |
Marker Test Method |
| Use Pick List |
Intensity Score |
| Use Pick List |
Cell Staining % |
| Number(3) |
Mutation Detected | INDETERMINATE | Use Pick List |
Result | NEGATIVE | Use Pick List |
Biomarker Comments | Enter the comments | 200 characters |
Path Report Description | Enter desctioption of pathology report | 200 characters |