Lymph node regional group 11 lymphadenectomy carcinoma metastatic involved number 2 total number 12 Lung left status post neoadjuvant therapy pneumonectomy 1 scar compatible with treatment effect 2 harmatoma Lymph node mediastinum group 56 lymphadenectomy no evidence of metastasis total number 4 Lymph node mediastinum group 7 lymphadenectomy no evidence of metastasis total number 2 Gross Description Specimen ”Left lung” 1. Specimen lung 2. Specimen size  21 x 12 x 2.2 cm 3. Tumor Site Peribronchial large and peripheral small 4. Tumor Size  Multiple Number 2  - large 5 x 3.5 x 2.5 cm - small 0.6 x 0.5 x 0.5 cm 5. Tumor gross configuration  large ill-define tan elastic-soft  small well-defined white firm 6. Pleural retraction not identified 7. Obstructive pneumonia not identified Specimen ”LN56” one fragment 1.3 x 1 x 0.5 cm Specimen ”LN7” two fragments up to 0.8 x 0.6 x 0.3 cm Representative sections are taken and labeled as A1-4 P large tumor A5 small tumor B non-tumor lung C bronchovascular margin D LN56 E LN7 F1-2 regional lymph node Microscopic 1. Diagnosis  squamous cell carcinoma in lymph nodes  large tumor fibrosis and foamy cell aggregates compatible with treatment effect  small tumor hamartoma 2. Tumor size  Not seen in the lung parenchyma 3. Histological Grade IASLC Histopathologic Grading  G3 Poorly differentiated any tumor with ＞ 20 high-grade pattern i.e. solid micropapillary cribriform or complex glandular pattern 4. Section Margin  pulmonary parenchymal margin uninvolved 5. Lymphovascular Invasion  Not Present 6. Visceral Pleural Invasion  The tumor does not invade the visceral pleura PL0. 7. Spread Through Air Spaces Not identified 8. Pathologic Staging pTNMAJCC 8th edition 1. Primary Tumor T ypT0 No evidence of primary tumor 2. Lymph Nodes N ypN1 Metastasis in ipsilateral peribronchial andor ipsilateral hilar lymph nodes and intrapulmonary nodes including involvement by direct extension Nodal Status N1 Number involved  Number examined group 11 Interlobar 2  12 N2 Number involved  Number examined Left group 56 0  2 Left group 7 0  4 Extranodal extension - 9. Treatment Effect Less than or equal to 10 residual viable tumor 10. Comment  The tumor cells are positive for p40 and negative for TTF1 EBER and p16. A squamous cell carcinoma is considered.  The viable tumor cells are only found in the lymph nodes.  The small tumor shows a hematoma. 醫師您好我看了我父親左肺全切後的病理報告，因為手術前有做過新輔助治療（化療免疫）所以手術後分期寫T0N1 胸外科醫師說可以追蹤就好但是我聽說只要淋巴轉移就得做術後的預防性化療，想詢問醫師若是因為新輔助治療後主腫瘤驗不到癌細胞但有顆淋巴轉移那這樣還需要做術後的化療嗎？那目前肺鱗癌的術後化療的療程通常都是什麼？
Dear Mark 1 術前已做過新輔助治療 術後手術T0N1  是可以追蹤就好 2 目前術後的輔助化療是用溫諾平柏金 4 次療程 彰化醫院關心您