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PATHOLOGY REPORT; SKIN(MELANOMA)
Department of Pathology
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Date of Submission |
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Date of Operation |
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Clinical History
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Clinical Diagnosis |
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Previous Surgical Number(s) |
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Previous Cytology Number(s) |
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Name of the Clinician |
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Patient Name |
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Patient Identification number |
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Patient Social Security Number |
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Surgical Pathology Number |
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Surgical Specimen |
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Operation type |
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- Biospsy |
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- Excisional biopsy |
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- Resection |
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- Other |
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Gross Description
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Microscopic Description |
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Special staining findings |
Non-applicable
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Immunohistochemical findings |
Non-applicable
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Ultrastructrual findings |
Non-applicable
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Additional studies |
Non-applicable
Non-applicable
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Final Diagnosis
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Tumor Type |
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Clark's Level |
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Breslow's Depth |
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Ulceration |
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Lymphoid Response |
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Regression |
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Associated Melanocytic Nevus |
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Margins of Excision |
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Deep Margins of Excision |
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Comments |
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Pathologist |
M.D. I am the pathologist who has reviewed this case
and rendered the above diagnosis.
Date |
