NSCLC Board Packet
Stage H · Human Review
J.D.
Right upper lobe lung adenocarcinomaMRN 887-204-119
F · 64yDx Feb 14, 2026Packet Mar 8, 2026, 05:42 PM
Source documents
5
Pathology ReportFeb 14, 2026Dr. Helena Park, MD — Anatomic Pathology
31 lines
Pathology Report
Surgical Pathology Report
MEMORIAL THORACIC PATHOLOGY · ACCESSION SP-26-018342
Patient: ANONYMIZED · MRN: 887-204-119 · DOB: 02/03/1962
Specimen received: 02/12/2026 Reported: 02/14/2026
 
SPECIMEN
A. Right upper lobe, CT-guided core biopsy (3 cores, 1.4 cm aggregate).
 
FINAL DIAGNOSIS
A. Right upper lobe, core biopsy:
INVASIVE ADENOCARCINOMA, acinar predominant, moderately differentiated.
Tumor involves all three cores; lymphovascular invasion present.
Background lung with mild centrilobular emphysema.
 
IMMUNOHISTOCHEMISTRY
TTF-1: positive (diffuse, strong)
Napsin A: positive
p40: negative
CK7: positive
Findings consistent with primary pulmonary adenocarcinoma.
 
CLINICAL HISTORY
64-year-old female, lifelong never-smoker, presenting with
3-week history of right-sided chest discomfort. CT chest demonstrated
a 3.2 cm spiculated mass in the right upper lobe with ipsilateral
mediastinal lymphadenopathy (subcarinal, 1.6 cm).
 
COMMENT
Tissue is sufficient and has been triaged for next-generation sequencing.
Recommend reflex molecular profiling per NCCN NSCL-G.
 
Electronically signed: H. Park, MD · 02/14/2026 16:42
Dr. Helena Park, MD — Anatomic Pathologydoc-path-001
Reconciled current state
Click any fact to trace its source

Missing workup

4 items

Required tests and studies that have not yet been ordered or returned. Resolve before submitting to tumor board.

  • KRAS G12C mutation testingcriticalBiomarkerNCCN NSCL-G (v3.2026)

    Initial NGS panel did not cover KRAS hotspots. Required to evaluate sotorasib / adagrasib eligibility before tumor board.

  • Whole-body PET/CTwarningImagingNCCN NSCL-2

    Pending per radiology recommendation; needed to exclude occult M1 disease prior to definitive intent.

  • Contrast-enhanced brain MRIwarningImagingNCCN NSCL-2

    Standard of care for Stage IIIA NSCLC to rule out asymptomatic CNS metastasis.

  • Pulmonary function testing (FEV1 / DLCO)infoLabs

    Required if surgical resection or curative-intent radiation is being considered.

Conflicts requiring resolution

The pipeline could not reconcile these values automatically.

1
PD-L1 TPS2 candidates

Recommendation: Both candidates are clinically meaningful. Prefer the assay with greatest tumor representation (SP263, deeper level).

45%Feb 21, 2026
Molecular Pathology — Initial NGS Panel

“Tumor Proportion Score (TPS): 45% · clone 22C3 (Dako)”

80%Mar 4, 2026
Molecular Pathology — Repeat PD-L1 IHC

“Tumor Proportion Score (TPS): 80% · clone SP263 (Ventana)”

Clinical data

Reconciled diagnosis, staging and patient context.

4 facts

Molecular biomarkers

Driver mutations, fusions and PD-L1 expression.

Generated from 5 source documents · every fact carries provenance to the originating PDF.ingest-svc 0.7.2 · reconcile 0.4.1