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

<Prostate xmlns="http://hl7.org/fhir" id="Prostate-genexample-5">
  <subject>
    <reference value="Patient/8003608666698535"/>
  </subject>
  <requester>
    <reference value="Practitioner/8003616566682137"/>
  </requester>
  <performer>
    <reference value="Organization/8003623233350148"/>
  </performer>
  <preAnalytic>
    <clinicalHistory value="Core biopsy Gleason score: 4+5=9"/>
    <psa>
      <value value="10"/>
      <unit value="ng/mL"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="ng/mL"/>
    </psa>
  </preAnalytic>
  <macro>
    <specimenWeight>
      <value value="35"/>
      <unit value="g"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="g"/>
    </specimenWeight>
    <specimenDimension1>
      <value value="45"/>
      <unit value="mm"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mm"/>
    </specimenDimension1>
    <specimenDimension2>
      <value value="35"/>
      <unit value="mm"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mm"/>
    </specimenDimension2>
    <specimenDimension3>
      <value value="27"/>
      <unit value="mm"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mm"/>
    </specimenDimension3>
    <otherMacroComments value="Volume: 3.3cm3 (3D volume estimate method)."/>
  </macro>
  <micro>
    <tumourType value="45410002"/>
    <tumourFocality value="Multifocal"/>
    <histologicalGrade>
      <primary value="369773008"/>
      <secondary>
        <value value="369774002"/>
      </secondary>
      <tertiary>
        <value value="369772003"/>
      </tertiary>
      <score
             value="Composite Gleason Score (ISUP) 2005): 4+5=9
Index carcinoma score (ISUP 2005): 4+5=9
% High Grade (4/5): 90%.
Intraduct carcinoma: Absent."/>
    </histologicalGrade>
    <extraprostaticExtension>
      <code value="372306004"/>
      <extent value="420366008"/>
      <location value="Posterolateral"/>
      <comment value="Measurement (radial): 0.4mm"/>
    </extraprostaticExtension>
    <margin>
      <status value="55182004"/>
      <locationDescription
                           value="Tumour location:  
Quadrants: All four
Zones:Peripheral, base and apex"/>
    </margin>
    <seminalVesicles value="not_involved"/>
    <lymphNodeStatus>
      <number>
        <value value="5"/>
      </number>
      <numberPositive>
        <value value="0"/>
      </numberPositive>
      <sitesInvolved value="Not involved"/>
      <invasion value="not_identified"/>
    </lymphNodeStatus>
  </micro>
  <synthesisOverview>
    <tumourStageT value="384987006"/>
    <diagnosticSummary
                       value="1. Radical prostatectomy: Adenocarcinoma
2. Right pelvic lymph nodes: No evidence of malignancu (0/4)
3. Periprostatic fat: No evidence of malignancy"/>
    <overarchingComment
                        value="Supplementary report by Dr F Maclean:
The specimen jar has been examined and no residual tissue is apprarent.  Multiple deeper levels of the blocks have been examined and an additional small benign lymph node measuring less than 1mm in maximum dimension has been identified. There is no additional evidence of malignancy. The above synpotic has been amended to reflect the resence of this node."/>
  </synthesisOverview>
</Prostate>