DR (MDM) LIM KENG JOO Obstetrician & Gynaccologist py JOHOR SPECIALIST HOSPITAL 9B, Jalan Abdul Samad 9100, Johor Bahru, Johor 1e : CHONG CHOK Pationt Name : Ch THYE OU TAU Ward / Clinic: CLINIC LabNo, 0816400091, hoe say Sex : Female Date Received : 1901/2016 ICNo. 610928-08-5110 MRN: 00726404 Date Reported : 26/01/2016 HISTOPATHOLOGY REPORT SPECIMEN A) Cervix, Uterus, Right Ovary And Fallopian Tube B) Left Lateral Vaginal Wall Tissue C) Right Pelvic Lymph Nodes D) Left Pelvic Lymph Nodes GROSS DESCRIPTION A) CERVIX, UTERUS, RIGHT OVARY AND FALLOPIAN TUBE Total abdominal hysterectomy and bilateral salphingo-oophorectomy weighing 93 grams, Uterus and cervix measure 100mm fundus to cervix, 55 mm bicornuate dimensions and 45mm anterior to posterior. Uterine cervix is circumferentially rimmed by vaginal tissue measuring 100mm in ircumference and 10mm in maximum length, A visible cervical tumour is seen predominantly present within the anterior aspect of the cervix. Tumour measures 30 mm in maximum horizontal dimensions. Tumour exhibits stromal invasion and approximately Smm from the nearest anterior parametrial margin. Endometrium is not involved by tumour. Myometrium is unremarkable. Right ovary measures 30 x 20x 15mm, unremarkable. Right fallopian tube measures 70 x 5 x Smm, unremarkable. Left ovary measures 25 x 15 x 10mm, unremarkable, Left fallopian tube ‘measures 70 x 5 x Smm, unremarkable. Representative tissue samples submitted as follows: Block A1 - Tumour with parametrium and anterior vaginal margin. Block A2 - Tumour with post parametrial and vaginal mar Block A3 - Tumour with right parametrial and vaginal margin. Block Ad - Tumour with left parametrial and vaginal margin. Block AS - Endomyometrium and serosa. Block A6 - Right ovary. Block A7 - Right fallopian tube and para adnexal soft tissue. Block A8- Left ovary. Block A9 - Left fallopian tube and para adnexal soft tissue. Block A10-- Right parametrial soft tissue. Block ALI - Left parametrial soft tissue. B) LEFT LATERAL VAGINAL WALL TISSUE Dr. Sri Ganesh Kalimuthu MB, BCh BAO Bed Sei, FRCPath (UK), IFCAP, MIAC wee bd rcp ‘Consultant Pathologist, Electronically Validated Report. No Signature Require. eeSS _ MEDICAL LABORATORY — pp (MDM) LIM KENG JOO a Soa De yewician & Gynaccologist ey SOHOR SPECIALIST HOSPITAL Sop, Jalan Abdul Samad £0100, Johor Bahru, Johor Patient Name : CHONG CHOK THYE UU 0 Ward /Clinic = CLINIC Lab No. ‘0816400091 a say Sex : Female Date Received : 19/01/2016 Ice. .610929-08-5110 MRN: 00726494 Date Reported. : 26/01/2016 Faceived a congested portion of mucosal tissue measuring 40 x 10mm, Tissue serially sliced and entirely submitted in two blocks. © RIGHT PELVIC LYMP! NODES Received multiple portions of fatty tissue measuring 90mm in aggregates. Multiple levels harvested and submitted as follows: Block Cl- One lymph node. Block C2 - One lymph node. Blocks C3 to CS - Multiple lymph nodes. D) LEFT PELVIC LYMPH NODES Received multiple portions of fatty tissue measuring 75mm in aggregates. Multiple lymph nodes harvested and submitted as follows: Block DI - One lymph node. Block D2 - One lymph node. Block D3 - One lymph node. Blocks D4 and DS - Multiple lymph nodes. MICROSCOPIC DESCRIPTION A) CERVIX, UTERUS, RIGHT OVARY AND FALLOPIAN TUBE Tumour morphological phenotype: Invasive moderately to poorly differentiated endocervical adenocarcinoma, Horizontal extent of tumour: 35mm, Lymphovascular invasion: Present Degree of stromal invasion: ‘Tumour invasion into stroma : 8mm | Stromal thickness : 15mm ‘Tumour invasion to stromal thickness ratio : 8:15 Margin status: Anterior parametrial margin: Smm Dr. Sri Ganesh Kalimuth MB, BCh BAO Bmed Sei, FRCPath (UK), IFCAP, MIAC ue ‘Consultant Pathologist Electronically Validated Report. No Signature RequiredsypM LIM KENG JOO Dan Cyractogt Oe SPECIALIST HOSPITAL, ln abl Samad Sree har aha, oor patient Name : CHONG CHOK THYE AU ‘ward /Clnie = CLINIC LabNo. —— : 0616400001 ie sty Sex : Female Date Received : 19/01/2016 Ic. 610828-06-5110 MRN: 00726404 Date Reported : 2601/2016 eee Grterior vaginal margin: Smm Posterior parametrial margin : 8mm Posterior vaginal margin : Smm Right parametrial margin Greater than 10mm Right vaginal margin Greater than 10mm Left parametrial margin: Smm Left vaginal margin : Smm Endometrium: trophic endometrium, No evidence of tumour involvement. Myometrium: Focal adenomyosis. ‘No evidence of tumour involvement. Right and left ovaries: No evidence of tumour involvement. Right and left fallopian tubes: No evidence of tumour involvement. Right and left fallopian tubes: No evidence of tumour involvement. Right and left parametrial soft tissues: [No evidence of tumour involvement. Right pelvic lymph nodes(Submitted as Specimen B): Fifteen lymph nodes exhibit reactive parenchymal changes. There is no evidence of metastatic carcinoma (0/15) Dr, Sri Ganesh Kalimuthu iN MB, BCh BAO ined Si, FRCPath (UK), IFCAP, MIAC wettt Consultant Pathologist xetronially Validated Report. No Signature Required {oe err SF IL rra DM) LIM KENG JOO a DR & Gynaecol oO SPECIALIST HOSPITAL an Abul Samad aster Bah, Johor patient Name : CHONG CHOK THYE UVLO ‘ward /Cinic. : CLINIC Lab No. 816400001 ie say Sex : Female Date Received : 1911/2016 ih 610920-08-5110 RIN: 00728404 Date Reported : 26/01/2016 see cece eS EE Left pelvic lymph nodes Submitted as Speeimen C): Fourteen lymph nodes exhibit reactive parenchymal changes. ‘There is no evidence of metastatic carcinoma (0/14) B) LEFT LATERAL VAGINAL WALL TISSUE. Sections comprises portions of vaginal mucosal tissue which are within normal limits. There is no evidence of dysplasia or malignancy (© RIGHT PELVIC LYMPH NODES Fifteen lymph nodes exhibit reactive parenchyma changes. ‘There is no evidence of metastatic carcinoma (0/15). D) LEFT PELVIC LYMPH NODES Fourteen lymph nodes exhibit reactive parenchyma changes. There is no evidence of metastatic carcinoma (0/14), DIAGNOSIS A) CERVIX, UTERUS, RIGHT OVARY AND FALLOPIAN TUBE Invasive moderately to poorly differentiated endocervical adenocarcinoma. Pathological staging (TNM [FIGO)): pT 1b [IB1] pNO pMX B) LEFT LATERAL VAGINAL WALL TISSUE Sections comprises portions of vaginal mucosal tissue which are within normal limits, No evidence of dysplasia or malignancy. (©) RIGHT PELVIC LYMPH NODES :- Fifteen lymph nodes exhibit reactive parenchymal changes. There is no evidence of metastatic carcinoma (0/15). D) LEFT PELVIC LYMPH NODES Fourteen lymph nodes exhibit reactive parenchymal changes. ‘There is no evidence of metastatic carcinoma (0/14). Dr. Sri Ganesh Kalimutho [MB, BCh BAO Bined Se, FRCPath (UK). IFCAP, MIAC reat! Consult Pathologist tecroically Validated Report No Signature Required sunt ei M20 FM ean TEE; 6 GS “ Allianz @ CRITICAL ILLNESS CLAIM FORM. [ATTENDING PHYSICIAN'S STATEMENT ‘AgencylAgent’s Code Policy No. Service No (tfce use only) 1 This print form is issue on receipt of notice of lines, and sno way an admission of tity, 2 This formis tobe completed by he Atending Doctor tclamants expenses. 3 For Creal ness claim, the orignal or certified tne copy ofthe investigation or histloay enor mustbe attached ip substantiate the cin, DEFINITION, en a ale a ‘Amalgnanttunou charactnsed bythe uncrtled growth and spread of malign calls and invasion of esue and desructon of normal sue fr which najpriarenonst weabrart or u3e(exutng tercoecopie proved tne) is constered nacessary The crear mat be cone by hla tvcence of mslgnsncy “The folowing canon ae excused 1 Caroma matunga ie cevi, 2 ductal canoe in sto te bros 2 papillary carcinoma ofthe adr and Stage 1 Prostate Canes, 4 allskn cancers except matgnant mela, 5 Stage | Hodgks dbeose 65 Tumous mantesing 2s complestions of ADS ‘PERSONAL PARTICULAR fh Name ok Thye tone = b1092 908 SHO b SF yr (Occupation Ago'Sex 1 a Please give deals of your paints smoking habits, both past and prosont m lz Ave you aware of any members ofthe patent's cose family who have sued rom tis or any similar conden? ives pare gre des, yy TLUNESS. |s Date you frst saw the paint otis concton (STOTT commer, |5 Was the patient refered to your cine by any ther doctor? yes, please indicate name and address of eon Seon Yet, Vik Waker (oiler theabetf 17 wnat were the symptoms the patient gomplant of when helshe fst saw you? 3 rt lee _Azorrg tte tet woop hte been xperenng hese syrtom prera cnn yO? Peers ese ROMO sea [2 tn your professional opinion, how long woul it take for the patient condition to develop 7 Kindly advise reson anor a8) 8 rr op CANCERISEPTEMAER 2003,oF hn see Tit was Your agnosis? Kindy ais Gta of Bags + pacross : ceryceal cance oo: [[TSCTA7T6) comm Allianz @ 1 Give det pt ro nge of pou . i ‘enh endo cerve lenecerire fi Please give an exact description of the ste ofthe tumour si Iv Please confirm the siagng of tumour stage ‘v- Would you classify your patients condtion as our definion ? Piease give deals sete ae “Dethunats hprerer bog Ilateal sol h7 OL athe, 2 edema ean aepapicatons tans) Jes ET No 13. Have te patent previously received treatment forthe above condtion? —[] ves [Eo tyes, please give details of teaiment inclusive of date, name and address of the doctor. bate Decors name and adress estat «Pepe egy ob nfo ich youl wad beh nh aptessmextt your patents am Fad” lar lig ge repthlg or Ser a D unl} es L ‘GENERAL FORMATION 15 Are youthe patents Usual Medical Attendant? Ifo, since when? \s0irg 1 to,se ge nae and aes seer Ui Mad Ate known Prease state from your records the deals of aliinesses, accidents, surgical operations o disease from which the patient had suffered orhad been treated at your cnc. (Please use addtional sheet, f necessary. joate Date of Consutstion Diagnosis Treatment BREEKENG JOO. erat cqr hat have evan te Soave paont and at Ne efusetetnase sad above represent my mecca ofrify of te patient's condition. ‘AN Mal) MBBS (Me) FRCOG (London) (CONSULTANT OBCTEVRICAN & GYNAECOL _agolios SF eciAL1OT HOSPTT Name of Decor Sienature Qualification > 3p o0r(6 * Sane bien thor ——— CANCERISEPTEMBER 2003