This page is part of the RCPA Cancer Protocols IG (v0.1.0: Release 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions

Generated Example

{
  "resourceType" : "Colorectal",
  "id" : "Colorectal-genexample-6",
  "subject" : {
    "reference" : "Patient/8003608166687541"
  },
  "requester" : {
    "reference" : "Practitioner/8003616566682137"
  },
  "performer" : {
    "reference" : "Organization/8003623233350148"
  },
  "preAnalytic" : {
    "clinicalInformation" : "R colon",
    "perforation" : "2667000",
    "clinicalObstruction" : "2667000",
    "tumourLocation" : [
      "9040008"
    ],
    "typeOfOperation" : {
      "code" : "235326000"
    },
    "preoperativeRadiotherapy" : "373067005"
  },
  "macro" : {
    "specimenLength" : {
      "value" : 155,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "tumourSite" : "9040008",
    "maxTumourDiameter" : {
      "value" : 23,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "distanceNearerProxOrDistal" : [
      {
        "value" : 40,
        "unit" : "mm",
        "system" : "http://unitsofmeasure.org",
        "code" : "mm"
      }
    ],
    "distNonperitonCircumMargin" : {
      "value" : 30,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "tumourPerforation" : "2667000",
    "lymphNodes" : "440622005",
    "otherMacroComments" : "(Query add the narrative comments here)",
    "natureAndSiteOfBlocks" : [
      "Block A - margins,
B - appendix tip,
C - appendix body and base,
D to I - tumour,
J - apical node bisected,
K - periapical node bisected,
L to R - four lymph nodes each,
S - one bissected lymph node,
T to V - remainder of appendix,
W to Y - caecal base,
Z to AA - terminal ileum. PL4"
    ]
  },
  "micro" : {
    "tumourType" : "35917007",
    "histologicalGrade" : "399415002",
    "maxDegreeLocalInvasion" : "395707006",
    "proximalOrDistalResectionMargins" : "not_involved",
    "marginsMicroClearance" : "30mm",
    "nonperitonealisedCircumMargin" : "not_involved",
    "microClearanceRectum" : {
      "value" : 30,
      "unit" : "mm",
      "system" : "http://unitsofmeasure.org",
      "code" : "mm"
    },
    "lymphNodeInvolvement" : "52101004",
    "lymphNodesDetails" : [
      {
        "site" : "pN1b",
        "numPos" : "3",
        "numExamined" : "31"
      }
    ],
    "intramuralVeinInvasion" : "not_identified",
    "extramuralVeinInvasion" : "not_identified",
    "smallVesselInvasion" : "395717001",
    "perineuralInvasion" : "369731000",
    "histoConfDistMetastases" : "2667000",
    "relCoexistPathabnorm" : [
      {
        "other" : "Mixed adenoneuroendocrine carcinoma of the appendix (See above description) - pT4a, pN0, Mx, Stage IIB.
Low grade appendiceal mucinous neoplasm (LAMN)"
      }
    ],
    "microResidualTumourStatus" : "R0 - No residual tumour"
  },
  "_ancillaryTests" : {
    "mlh1" : "normal_staining",
    "pms2" : "normal_staining",
    "msh2" : "normal_staining",
    "msh6" : "normal_staining",
    "comments" : "Immunoperoxidase stains show preservation of nuclear staining in the tumour cells for the DNA mismatch repair enzymes hMLH1, hMSH2, hMSH6 and PMS2, so that high-level microsatellite instability (MSI-H) is very unlikely.
MSI stains were also performed on the mixed adenoneuroendocrine carcinoma and the tumour cells display preservation of nuclear staining for PMS2, MLH1, MSH6 and MSH2 indicating a low probability of microsatellite instability.",
    "msi" : {
      "code" : "373121007"
    },
    "braf" : {
      "code" : "373121007"
    },
    "kras" : {
      "code" : "373121007"
    }
  },
  "synthesisOverview" : {
    "tumourStageT" : "395707006",
    "tumourStageN" : "n1b",
    "tumourStageM" : "mx",
    "tumourStageGrouping" : "261639007",
    "tumourStagingSystem" : "AJCC 2010, 7th edition",
    "residualTumourStatus" : "r0",
    "overarchingComment" : "It is difficult to be accurate as regards to size of the adenoneuroendocrine carcinoma in the appendix.  However, adding together all the blocks that contain the tumour, the estimated maximum tumour size is 25mm in length."
  }
}