Definition/General
Clinical Features
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Gross Description
Microscopic Description
Immunohistochemistry
Molecular/Genetic
Differential Diagnosis
Sample Pathology Report
Template Format
Sample Pathology Report
Complete Report: This is an example of how the final pathology report should be structured for this condition.
Specimen Information
Vulvar excision from [site], measuring [size] cm with extensive necrosis
Diagnosis
Small cell neuroendocrine carcinoma
Classification
Type: Small cell carcinoma, Grade: High-grade (Grade 3), Primary vs Metastatic: [assessment]
Histological Features
Shows [small cell morphology] with [high mitotic activity] and [extensive necrosis]
Small Cell Features
Cell size: [2-3x lymphocyte], chromatin: [salt-and-pepper], cytoplasm: [scant], mitoses: [>20/10 HPF]
Necrosis and Invasion
Necrosis: [extensive, >50%], lymphovascular invasion: [present], perineural invasion: [present/absent]
Tumor Size
Tumor size: [X] cm, viable tumor: [X] cm (after excluding necrosis)
Margins
Margins: [involved/close/clear], closest margin [X] mm
Special Studies
Neuroendocrine markers: Chromogranin: [result], Synaptophysin: [result], INSM1: [result]
TTF-1: [positive/negative] (primary vs metastatic assessment)
Ki-67 proliferation index: [X]% (high-grade)
Primary vs Metastatic Assessment
Assessment: [primary vulvar/metastatic from lung/indeterminate], TTF-1: [result], clinical correlation recommended
Prognostic Factors
Poor prognostic factors: small cell histology, high grade, extensive necrosis, early metastasis
Final Diagnosis
Vulvar small cell neuroendocrine carcinoma, high-grade, [primary/metastatic assessment]
Clinical Note
Note: Extremely aggressive tumor requiring urgent multidisciplinary management and staging