Lithuanian Cervical Cancer Implementation Guide, published by Lithuanian Medical Library. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7LT/ig-lt-cervical/ and changes regularly. See the Directory of published versions

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: DiagnosticReport: Cervical Histopathology Report (example)

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<DiagnosticReport xmlns="http://hl7.org/fhir">
  <id value="diagnosticreport-histopathology-example"/>
  <meta>
    <profile
             value="https://hl7.lt/fhir/cervical/StructureDefinition/histopathology-diagnostic-report-lt-cervical"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="generated"/>
    <div xml:lang="en" lang="en"><hr/><p><b>English</b></p><hr/><p class="res-header-id"><b>Generated Narrative: DiagnosticReport diagnosticreport-histopathology-example</b></p><a name="diagnosticreport-histopathology-example"> </a><a name="hcdiagnosticreport-histopathology-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-histopathology-diagnostic-report-lt-cervical.html">DiagnosticReport: Cervical Histopathology (LT Cervical)</a></p></div><h2><span title="Codes:{http://snomed.info/sct 714797009}">Histologic test (procedure)</span> (<span title="Codes:{http://loinc.org 11526-1}">Pathology study</span>) </h2><table class="grid"><tr><td>Subject</td><td>Janette Petrauskaite(official) Female, DoB: 1985-01-01 ( http://hospital-lt.lt/patient-id#HOSPLT-10005 (use: usual, ))</td></tr><tr><td>When For</td><td>2025-04-10 09:00:00+0200</td></tr><tr><td>Reported</td><td>2025-04-15 16:00:00+0200</td></tr><tr><td>Performer</td><td> <a href="Practitioner-practitioner-example.html">Practitioner Dr. Petras Kazlauskas(official)</a></td></tr><tr><td>Identifier</td><td> <code>urn:oid:2.16.840.1.113883.4.330.1</code>/HIST-CERV-2025-0042</td></tr></table><p><b>Report Details</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td></tr><tr><td><a href="Observation-observation-histopathology-conclusion-example.html"><span title="Codes:{http://snomed.info/sct 371528001}">Pathology report (record artifact)</span></a></td><td><span title="Codes:{http://snomed.info/sct 400049009}">Squamous intraepithelial neoplasia grade 2 (morphologic abnormality)</span></td><td>Final</td></tr><tr><td><a href="Observation-observation-tumor-measurement-cervical-example.html"><span title="Codes:{http://snomed.info/sct 263605001}">Tumor size</span></a></td><td/><td>Final</td></tr></table><div><p>High-grade squamous intraepithelial lesion (HSIL/CIN2). Clear surgical margins. No lymphovascular invasion.</p>
</div><p><b>Coded Conclusions:</b></p><ul><li><span title="Codes:{http://hl7.org/fhir/sid/icd-10 D06.9}">Carcinoma in situ of cervix uteri, unspecified</span></li></ul></div>
  </text>
  <identifier>
    <system value="urn:oid:2.16.840.1.113883.4.330.1"/>
    <value value="HIST-CERV-2025-0042"/>
  </identifier>
  <status value="final"/>
  <category>
    <coding>
      <system value="http://loinc.org"/>
      <code value="11526-1"/>
      <display value="Pathology study"/>
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="714797009"/>
      <display value="Histologic test (procedure)"/>
    </coding>
  </code>
  <subject>🔗 
    <reference value="Patient/patient-female-example"/>
  </subject>
  <effectiveDateTime value="2025-04-10T09:00:00+02:00"/>
  <issued value="2025-04-15T16:00:00+02:00"/>
  <performer>🔗 
    <reference value="Practitioner/practitioner-example"/>
  </performer>
  <specimen>🔗 
    <reference value="Specimen/specimen-cervical-biopsy-example"/>
  </specimen>
  <result>🔗 
    <reference
               value="Observation/observation-histopathology-conclusion-example"/>
  </result>
  <result>🔗 
    <reference
               value="Observation/observation-tumor-measurement-cervical-example"/>
  </result>
  <conclusion
              value="High-grade squamous intraepithelial lesion (HSIL/CIN2). Clear surgical margins. No lymphovascular invasion."/>
  <conclusionCode>
    <coding>
      <system value="http://hl7.org/fhir/sid/icd-10"/>
      <code value="D06.9"/>
      <display value="Carcinoma in situ of cervix uteri, unspecified"/>
    </coding>
  </conclusionCode>
</DiagnosticReport>