MSH|^~\&|ILS|INDEPENDENT LAB SERVICES-NY^33D1234567^CLIA|ECLRS|NYSCR|200407281339||ORU^R01^ORU_R01|2004072813390045|P|2.5.1|||||||||VOL_V_30_ORU_R01^NAACCR_CP^2.16.840.1.113883.9.8^ISO PID|1||123456789^^^^SS|000039^^^^LR|McMuffin^Candy^^^Ms.||19570706|F||2106-3|495 East Overshoot Drive^^Delmar^NY^12054^^H||^^^^^518^5559999|||M|||4442331235 PV1|1|N|||||594110NY^CARING^CAREN^^^DR|59411ONY^CARING^CAREN^^^DR ORC|RE||||||||||||||||||||Albany Medical Center^^123456^^^AHA|43 New Scotland Ave^^Albany^NY^12208|^^^^^518^3334444|100 Provider St^^Albany^NY^12205 OBR|1||97 810430|11529-5^SURGICAL PATH REPORT^LN^^PATHOLOGY REPORT^L|||20040720|||||||||123456^MYELOMUS^JOHN^^MD|^^^^^518^4244243|||||20040728|||F|||||||109771&GLANCE&JUSTIN&A&MD&&&&NY_PHYSICIANLICENSE OBX|1|TX|22636-5^CLINICAL HISTORY^LN||47-year old white female with (L) UOQ breast mass||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|2|TX|22638-1^COMMENTS^LN||Carcinoma of breast. Post operative diagnosis:same||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA SPM|1|^97 810430-1&ILSPCID||TISS^Tissue^HL70487|||||||||||||200407200930|200407211500||||||||||||0704500123^^^33D1234567&INDEPENDENT LAB SERVICES OBX|3|TX|22633-2^Nature of Specimen^LN^L47^SUBMITTED TISSUE^L|1|left breast biopsy||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|4|TX|22634-0^Gross Pathology^LN^L567^GROSS PATHOLOGY^L|1|Part #1 is labeled "left breast biopsy" and is received fresh after frozen section preparation. It consists of a single firm nodule measuring 3cm in circular diameter and 1.5cm in thickness surrounded by adherent fibrofatty tissue. On section a pale gray, slightly mottled appearance is revealed. Numerous sections are submitted for permanent processing. ||||||F|||200407280841|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|5|TX|22635-7^Microscopic Pathology^LN^L589^MICROSCOPIC^L|1|Sections of part #1 confirm frozen section diagnosis of infiltrating duct carcinoma. It is to be noted that the tumor cells show considerable pleomorphism, and mitotic figures are frequent (as many as 4 per high power field). Many foci of calcification are present within the tumor.||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|6|TX|22637-3^Path report.final diagnosis^LN|1|1. Infiltrating duct carcinoma, left breast.||||||F|||200407280841|33D1234567^INDEPENDENT LAB SERVICES^CLIA SPM|2|^97 810430-2&ILSPCID||TISS^Tissue^HL70487|||||||||||||200407200930|2004070211500||||||||||||0704500123^^^33D1234567&INDEPENDENT LAB SERVICES OBX|7|TX|22633-2^Nature of Specimen^LN^L47^SUBMITTED TISSUE^L|2|apical axillary tissue ||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|8|TX|22634-0^Gross Pathology^LN^L567^GROSS PATHOLOGY^L|2|Part #2 is labeled "apical left axillary tissue" and is received fresh. It consists of two amorphous fibrofatty tissue masses without grossly discernible lymph nodes therein. Both pieces are rendered into numerous sections and submitted in their entirety for history. ||||||F|||200407280841|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|9|TX|22635-7^Microscopic Pathology^LN^L589^MICROSCOPIC^L|2|Part #2 consists of fibrofatty tissue and single tiny lymph node free of disease.||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|10|TX|22637-3^Path report.final diagnosis^LN|2|2. Lymph node, no pathologic diagnosis, left axilla.||||||F|||200407280841|33D1234567^INDEPENDENT LAB SERVICES^CLIA SPM|3|^97 810430-3&ILS*PCID||TISS^Tissue^HL70487|||||||||||||200407200930|2004070211500||||||||||||0704500123^^^33D1234567&INDEPENDENT LAB SERVICES OBX|11|TX|22633-2^Nature of Specimen^LN^L47^SUBMITTED TISSUE^L|3|contents of left radical mastectomy ||||||F|||200407200930|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|12|TX|22634-0^Gross Pathology^LN^L567^GROSS PATHOLOGY^L|3|Part #3 is labeled "contents of left radical mastectomy" and is received flesh. It consists of a large ellipse of skin overlying breast tissue, the ellipse measuring 20cm in length and 14 cm in height. A freshly sutured incision extends 3cm directly lateral from the areola, corresponding to the closure for removal of part #1. Abundant amounts of fibrofatty connective tissue surround the entire beast and the deep aspect includes and 8cm length of pectoralis minor and a generous mass of overlying pectoralis major muscle. Incision from the deepest aspect of the specimen beneath the tumor mass reveals tumor extension gross to within 0.5cm of muscle. Sections are submitted according to the following code: DE- deep surgical resection margins; SU, LA, INF, ME -- full thickness radila samplings from the center of the tumor superiorly, laterally, inferiorly and medially, respectively: NI- nipple and subjacent tissue. Lymph nodes dissected free from axillary fibrofatty tissue from levels I, II, and III will be labeled accordingly. ||||||F|||200407280841|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|13|TX|22635-7^Microscopic Pathology^LN^L589^MICROSCOPIC^L|3|Part #3 includes 18 lymph nodes, three from Level III, two from Level II and thirteen from Level I. All lymph nodes are free of disease with the exception of one Level I lymph node, which contains several masses of metastatic carcinoma. All sections taken radially from the superficial center of the resection site fail to include tumor, indicating the tumor to have originated deep within the breast parenchyma. Similarly, there is no malignancy in the nipple region, or in the lactiferous sinuses. Sections of deep surgical margin demonstrate diffuse tumor infiltration of deep fatty tissues, however, there is no invasion of muscle. Total size of primary tumor is estimated to be 4cm in greatest dimension.||||||F|||200704110841|33D1234567^INDEPENDENT LAB SERVICES^CLIA OBX|14|TX|22637-3^Path report.final diagnosis^LN|3|3. Ext. of tumor into deep fatty tissue. Metastatic carcinoma, left axillary lymph node (1) Level I. Free of disease 17 of 18 lymph nodes - Level I (12), Level II (2) and Level III (3).||||||F|||200407280841|33D1234567^INDEPENDENT LAB SERVICES^CLIA