Form:Lung Reference Nodule Set C v1.0


CDE IDCDE Description
* 1063Site Participant ID (Go To: 422)
* 422EDRN Site ID (Go To: 2159)
* 2159Specimen line number or identifier (system-generated): (Go To: 423)
* 423EDRN Protocol ID (Go To: 1234)
   1234Chest X-ray date (MM/DD/YYYY): (Go To: 1235)
   1235Chest X-ray nodule size (cm): (Go To: 1236)
   1236Chest X-ray nodule location: (Go To: 2656)
   2656Chest X-ray nodule shape: (Go To: 1237)
 
Permissible Values (value):Smooth (0)
 
 Lobulated (2)
 
 Spiculated (5)
 
 Unknown (99)
   1237Chest CT date: (Go To: 1238)
   1238Chest CT nodule size (cm): (Go To: 1239)
   1239Chest CT nodule location: (Go To: 2657)
   2657CT nodule shape: (Go To: 1257)
 
Permissible Values (value):Smooth (0)
 
 Lobulated (2)
 
 Spiculated (5)
 
 Unknown (99)
   1257Histologic type (lung): (Go To: 1241)
 
Permissible Values (value):Squamous cell carcinoma (1)
 
 Papillary squamous cell carcinoma (2)
 
 Clear cell squamous cell carcinoma (3)
 
 Small cell squamous cell carcinoma (4)
 
 Basaloid squamous cell carcinoma (5)
 
 Small cell carcinoma (6)
 
 Combined small cell carcinoma (7)
 
 Adenocarcinoma (8)
 
 Acinar adenocarcinoma (9)
 
 Papillary adenocarcinoma (10)
 
 Bronchioloalveolar carcinoma (11)
 
 Non-mucinous (12)
 
 Mucinous (13)
 
 Mixed mucinous and non-mucinous or indeterminate (14)
 
 Solid adenocarcinoma with mucin formation (15)
 
 Adenocarcinoma with mixed subtypes (16)
 
 Large cell carcinoma (17)
 
 Other (95)
 
 N/A (98)
 
 Unknown/refused (99)
   1241Histologic dimensions - height (cm): (Go To: 1242)
   1242Histologic dimensions - width (cm): (Go To: 1243)
   1243Histologic dimensions - depth (cm): (Go To: 1244)
   1244Histologic dimensions - volume (ml): (Go To: 1245)
   1245Distance/pleural margin (mm): (Go To: 1246)
   1246Distance/bronchial margin (mm): (Go To: 720)
   720Anatomical site (Go To: 1097)
 
Permissible Values (value):Bladder (1)
 
 Bladder peritoneum (2)
 
 Bowel peritoneum/serosa (3)
 
 Corpus (4)
 
 Cervix (5)
 
 Cul-de-sac (6)
 
 Diaphram (7)
 
 Fallopian tube (8)
 
 Omentum (9)
 
 Paracolic gutter (10)
 
 Pelvic wall (11)
 
 Peritoneum/uterine serosa (12)
 
 Vagina (13)
 
 Ovary (14)
 
 Mainstem bronchus (15)
 
 Carina (16)
 
 Upper lobe (UL) (17)
 
 Lower lobe (LL) (18)
 
 Middle lobe (ML) (19)
 
 Ureter (20)
 
 Renal pelvis (21)
 
 Endometrium (22)
 
 Lymph node (25)
 
 Other (95)
 
 Responses are organ-specific (999)
   1097Comments (do not include any participant identifiers) (Go To: End of Form)