Specimen:
   Duodenum
   Ampulla of Vater
   Small intestine:
       Jejunum
       Ileum
       Unknown

Other organs received:
   Stomach
   Head of pancreas
   Common bile duct
   Gallbladder
   Cecum
   Right colon
   Appendix
   Other (specify):
   Not specified

Procedure:
Segmental resection
Ampullectomy
Pancreaticoduodenectomy (Whipple resection)
Other (specify):
Not specified

Specimen Size: cm

Tumor Site:
   Duodenum
   Ampulla
   Small bowel:
       Jejunum
       Ileum
   Other (specify):
   Not specified

Tumor Size:
   Greatest dimension: cm (specify size of largest tumor if multiple tumors are present)
   Additional dimensions: cm
   Cannot be determined (see Comment)

Tumor Focality:
Unifocal
Multifocal (number of tumors: )
Cannot be determined

Histologic Type:
Carcinoid tumor (low-grade neuroendocrine neoplasm)
Somatostatinoma
Gastrinoma
Gangliocytic paraganglioma
Other (specify):

Alternative Histologic Classification:
    Well-differentiated endocrine tumor, benign behavior
    Well-differentiated endocrine tumor, uncertain behavior
    Well-differentiated endocrine carcinoma

Histologic Grade:
Not applicable
GX: Cannot be assessed
G1: Low grade
G2: Intermediate grade
Other (specify):

For poorly differentiated neuroendocrine carcinomas arising in the small intestine or ampulla, the College of American Pathologists (CAP) checklists for carcinomas of those organ sites should be used

Mitotic Rate:
/10 high-power fields (HPF)
Cannot be determined

Microscopic Tumor Extension: Small Intestine:
   Cannot be assessed
   No evidence of primary tumor
   Tumor invades lamina propria
   Tumor invades submucosa
   Tumor invades muscularis propria
   Tumor invades subserosal tissue without involvement of visceral peritoneum
   Tumor penetrates serosa (visceral peritoneum)
   Tumor directly invades adjacent structures ()
   Tumor penetrates to the surface of the visceral peritoneum (serosa) and directly invades adjacent structures ()

Microscopic Tumor Extension: Ampulla:
   Cannot be assessed
   No evidence of primary tumor
   Tumor limited to ampulla of Vater or sphincter of Oddi
   Tumor invades duodenal wall
   Tumor invades pancreas
   Tumor invades peripancreatic soft tissues
   Tumor invades common bile duct
   Tumor invades other adjacent organs or structures:

Margins:
   Small Intestine Resection Specimen:
       Proximal Margin:
        Cannot be assessed
        Uninvolved by neuroendocrine tumor
        Involved by neuroendocrine tumor
       Distal Margin:
        Cannot be assessed
        Uninvolved by neuroendocrine tumor
        Involved by neuroendocrine tumor
       Mesenteric (Radial) Margin:
        Cannot be assessed
        Uninvolved by neuroendocrine tumor
        Involved by neuroendocrine tumor
       Other Margin(s) ():
        Not applicable
        Cannot be assessed
        Uninvolved by neuroendocrine tumor
        Involved by neuroendocrine tumor
   Ampullectomy Specimen:
    Margins cannot be assessed
    Margins uninvolved by neuroendocrine tumor, distance of neuroendocrine tumor from closest margin: at
    Margin(s) involved by neuroendocrine tumor ()
    Not applicable
Pancreaticoduodenal Resection Specimen (for ampullary tumors):
   Proximal Mucosal Margin (Gastric or Duodenal):
    Cannot be assessed
    Uninvolved neuroendocrine tumor
    Involved by neuroendocrine tumor
   Distal Margin (Distal Duodenal or Jejunal):
    Cannot be assessed
    Uninvolved by neuroendocrine tumor
    Involved by neuroendocrine tumor
   Pancreatic Retroperitoneal (Uncinate) Margin:
    Not applicable
    Cannot be assessed
    Uninvolved by neuroendocrine tumor
    Involved by neuroendocrine tumor (present 0-1 mm from margin)
   Bile Duct Margin:
    Not applicable
    Cannot be assessed
    Margin uninvolved by neuroendocrine tumor
    Margin involved by neuroendocrine tumor
   Distal Pancreatic Resection Margin:
    Not applicable
    Cannot be assessed
    Margin uninvolved by neuroendocrine tumor
    Margin involved by neuroendocrine tumor

Distance of tumor from closest margin: at

Lymph-Vascular Invasion:
Not identified
Present
Indeterminate

Perineural Invasion:
    Not identified
    Present
    Indeterminate

Pathologic Staging (pTNM)

TNM Descriptors:
       m (multiple primary tumors)
       r (recurrent)
       y (posttreatment)

Primary Tumor (pT):
pTX: Primary tumor cannot be assessed
pT0: No evidence of primary tumor
pT1: Tumor invades lamina propria or submucosa and size 1 cm or less (small intestinal tumors); tumor 1 cm or less (ampullary tumors)
pT2: Tumor invades muscularis propria or tumor size >1 cm (small intestinal tumors); tumor size >1 cm (ampullary tumors)
pT3: Tumor invades through the muscularis propria into subserosal tissue without penetration of overlying serosa (jejunal or ileal tumors) or invades pancreas or retroperitoneum (ampullary or duodenal tumors) or into nonperitonealized tissues
pT4: Tumor penetrates visceral peritoneum (serosa) or invades other organs

Regional Lymph Nodes (pN):
Cannot be assessed
pN0: No regional lymph node metastasis ( 0 / )
pN1: Metastasis in regional lymph nodes ( 0 / )
No nodes submitted or found

Distant Metastasis (pM):
    Not applicable
    pM1: Distant metastasis at

Ancillary Studies:
       Ki-67 index:
        ≤2%
        >2% to 20%
        >20%
       Other (specify):
       Not performed

Additional Pathologic Findings:
       Endocrine cell hyperplasia
       Tumor necrosis
       Psammoma bodies
       Mesenteric vascular elastosis
       Other (specify):

Comment(s):