COLON AND RECTUM: Resection, Including Transanal Disk Excision of Rectal NeoplasmsSpecimen: Terminal ileum Cecum Appendix Ascending colon Transverse colon Descending colon Sigmoid colon Rectum Anus Other (specify): Not specified Procedure Type: Right hemicolectomy Transverse colectomy Left hemicolectomy Sigmoidectomy Rectal/rectosigmoid colon (low anterior resection) Total abdominal colectomy Abdominoperineal resection Transanal disk excision (local excision) Other (specify): Not specified Specimen Length (if applicable)Specimen length: cm Tumor Site: Cecum Right (ascending) colon Hepatic flexure Transverse colon Splenic flexure Left (descending) colon Sigmoid colon Rectosigmoid Rectum Colon, not otherwise specified Cannot be determined (see Comment) Tumor Size: Greatest dimension (cm): Additional dimensions: x cm Cannot be determined (see Comment) Macroscopic Tumor Perforation: Present Not identified Cannot be determined Macroscopic Intactness of Mesorectum:Not applicable Complete Near complete Incomplete Cannot be determined Histologic Type:Adenocarcinoma Mucinous adenocarcinoma Signet-ring cell carcinoma Small cell carcinoma Squamous cell carcinoma Adenosquamous carcinoma Medullary carcinoma Undifferentiated carcinoma Other (specify): Carcinoma, type cannot be determined Histologic Grade: Not applicable Cannot be assessed Low-grade (well-differentiated to moderately differentiated) High-grade (poorly differentiated to undifferentiated) Other (specify): Histologic Features Suggestive of Microsatellite Instability: Intratumoral Lymphocytic Response (tumor-infiltrating lymphocytes): None Mild to moderate (0-2 per high-power (X400) field) Marked (3 or more per high-power field) Peritumor Lymphocytic Response (Crohn-like response): None Mild to moderate Marked Tumor Subtype and Differentiation: Mucinous tumor component (specify percentage: ): Medullary tumor component High histologic grade (poorly differentiated) Microscopic Tumor Extension: Cannot be assessed No evidence of primary tumor Intramucosal carcinoma, invasion of lamina propria Tumor invades submucosa Tumor invades muscularis propria Tumor invades through the muscularis propria into the subserosal adipose tissue or the nonperitonealized pericolic or perirectal soft tissues but does not extend to the serosal surface Tumor penetrates to the surface of the visceral peritoneum (serosa) Tumor is adherent to other organs or structures(specify: ): Tumor directly invades adjacent structures(specify: ): Tumor penetrates to the surface of the visceral peritoneum (serosa) and directly invades adjacent structures(specify: ): Margins: Proximal Margin: Cannot be assessed Uninvolved by invasive carcinoma Involved by invasive carcinoma Intramucosal carcinoma /adenoma not identified at proximal margin Intramucosal carcinoma/adenoma present at proximal margin Distal Margin: Cannot be assessed Uninvolved by invasive carcinoma Involved by invasive carcinoma Intramucosal carcinoma/adenoma not identified at distal margin Intramucosal carcinoma /adenoma present at distal margin Circumferential (Radial) or Mesenteric Margin: Not applicable Cannot be assessed Uninvolved by invasive carcinoma Involved by invasive carcinoma (tumor present 0-1 mm from margin) If all margins uninvolved by invasive carcinoma:Distance of invasive carcinoma from closest margin: at Lateral Margin (for non-circumferential transanal disk excision): Cannot be assessed Uninvolved by invasive carcinoma: Distance of invasive carcinoma from closest lateral margin: mm at specify o'clock if possible Involved by invasive carcinoma at specify o'clock if possible Uninvolved by adenoma Involved by adenoma Treatment Effect (applicable to carcinomas treated with neoadjuvant therapy)No prior treatment Present: No residual tumor (complete response, grade 0) Moderate response (grade 1, minimal residual cancer) Minimal response (grade 2) No definite response identified (grade 3, poor response) Not known Lymph-Vascular Invasion: Not identified Present Indeterminate Perineural Invasion: Not identified Present Indeterminate Tumor Deposits (discontinuous extramural extension)Not identified Present Indeterminate Type of Polyp in Which Invasive Carcinoma Arose: None identified Tubular adenoma Villous adenoma Tubulovillous adenoma Traditional serrated adenoma Sessile serrated adenoma Hamartomatous polyp Indeterminate Pathologic Staging (pTNM): TNM Descriptors (required only if applicable) (select all that apply)m (multiple primary tumors) r (recurrent) y (post-treatment) Primary Tumor (pT): pTX: Cannot be assessed pT0: No evidence of primary tumor pTis: Carcinoma in situ, intraepithelial (no invasion) pTis: Carcinoma in situ, invasion of lamina propria pT1: Tumor invades submucosa pT2: Tumor invades muscularis propria pT3: Tumor invades through the muscularis propria into pericolorectal tissues pT4a: Tumor penetrates the visceral peritoneum pT4b: Tumor directly invades or is adherent to other organs or structures Regional Lymph Nodes (pN): pNX: Cannot be assessed pN0: No regional lymph node metastasis ( 0 / ) pN1a: Metastasis in 1 regional lymph node ( 1 / ) pN1b: Metastasis in 2 to 3 regional lymph nodes ( / ) pN1c: Tumor deposit(s) in the subserosa, or non-peritonealized pericolic or perirectal tissues without regional lymph node metastasis ( 0 / ) pN2a: Metastasis in 4 to 6 regional lymph nodes ( / ) pN2b: Metastasis in 7 or more regional lymph nodes ( / ) Distant Metastasis (pM): Not applicable pM1: Distant metastasis at pM1a: Metastasis to single organ or site (eg, liver, lung, ovary, nonregional lymph node) pM1b: Metastasis to more than one organ/site or to the peritoneum Additional Pathologic Findings: None identified Adenoma(s) Chronic ulcerative proctocolitis Crohn disease Dysplasia arising in inflammatory bowel disease Other polyps (types): Other (specify): Ancillary Studies: Microsatellite instability: Stable Low High Immunohistochemistry Studies for Mismatch Repair Proteins: MLH1: Intact nuclear positivity, tumor cells Loss of nuclear positivity, tumor cells Pending Other (specify): MSH2: Intact nuclear positivity, tumor cells Loss of nuclear positivity, tumor cells Pending Other (specify): MSH6: Intact nuclear positivity, tumor cells Loss of nuclear positivity, tumor cells Pending Other (specify): PMS2: Intact nuclear positivity, tumor cells Loss of nuclear positivity, tumor cells Pending Other (specify): Mutational Analysis: BRAF V600E mutational analysis, testing method: Mutant BRAF detected No mutant BRAF detected (wild type BRAF allele) Other (specify): KRAS mutational analysis, testing method: Mutant KRAS detected (specify mutation) No mutant KRAS detected (wild type KRAS allele) Other (specify): Other, specify: Not performed Comments: