ARCHETYPE Microscopic findings - Melanoma of skin (openEHR-EHR-CLUSTER.microscopy_melanoma.v0)

ARCHETYPE IDopenEHR-EHR-CLUSTER.microscopy_melanoma.v0
ConceptMicroscopic findings - Melanoma of skin
DescriptionMicroscopic anatomic pathology findings related to melanoma of skin.
UseTo record detailed findings about microscopic examination of tissue. Use as a component archetype in the context of a suite of archetypes that make up a histopathology report ie OBSERVATION.lab_test.histopathology.
MisuseNot designed to be used within any other archetype other than OBSERVATION.lab_test.histopathology.
PurposeTo record detailed findings about melanoma of skin found on microscopic examination.
ReferencesRoyal College of Pathologists of Australasia. Primary Cutaneous Melanoma Structured Reporting Protocol (1st Edition 2010). [Internet]. 2010;[cited 2010 Mar 21 ]
Available from: http://www.rcpa.edu.au//static/File/Asset%20library/public%20documents/Publications/StructuredReporting/PRIMARY%20CUTANEOUS%20MELANOMA%20STRUCTURED%20REPORTING%20PROTOCOL.pdf

College of American Pathologists. Melanoma of the skin - Full protocol [Internet]. 2005 Jan ;[cited 2009 Jul 25 ]
Available from: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2005/skinmelanoma05_pw.pdf

New Zealand Guidelines Group. Histopathological reporting of cutaneous melanoma
In: Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand [Internet]. 2008 Nov ;[cited 2009 Jul 25 ]
Available from: http://www.nzgg.org.nz/guidelines/0141/Chapter_7___Histopathological_reporting_of_cutaneous_melanoma.pdf

Mitotic index - Wikipedia, the free encyclopedia [Internet]. [cited 2009 Jul 25 ]
Available from: http://en.wikipedia.org/wiki/Mitotic_index

Copyright© openEHR Foundation
AuthorsAuthor name: Dr Ian McNicoll
Organisation: Ocean Informatics, UK
Email: ian.mcnicoll@oceaninformatics.com
Date originally authored: 17/05/2009
Other Details LanguageAuthor name: Dr Ian McNicoll
Organisation: Ocean Informatics, UK
Email: ian.mcnicoll@oceaninformatics.com
Date originally authored: 17/05/2009
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, references=Royal College of Pathologists of Australasia. Primary Cutaneous Melanoma Structured Reporting Protocol (1st Edition 2010). [Internet]. 2010;[cited 2010 Mar 21 ] Available from: http://www.rcpa.edu.au//static/File/Asset%20library/public%20documents/Publications/StructuredReporting/PRIMARY%20CUTANEOUS%20MELANOMA%20STRUCTURED%20REPORTING%20PROTOCOL.pdf College of American Pathologists. Melanoma of the skin - Full protocol [Internet]. 2005 Jan ;[cited 2009 Jul 25 ] Available from: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2005/skinmelanoma05_pw.pdf New Zealand Guidelines Group. Histopathological reporting of cutaneous melanoma In: Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand [Internet]. 2008 Nov ;[cited 2009 Jul 25 ] Available from: http://www.nzgg.org.nz/guidelines/0141/Chapter_7___Histopathological_reporting_of_cutaneous_melanoma.pdf Mitotic index - Wikipedia, the free encyclopedia [Internet]. [cited 2009 Jul 25 ] Available from: http://en.wikipedia.org/wiki/Mitotic_index , original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=1267987C10638F469EA547A5859E9663, build_uid=358ccb69-42d7-4eca-8c2c-ec24a3251f31, revision=0.0.1-alpha}
Keywordsmelanoma, lab, malignancy, skin, dermatology, histology, histopathology, pathology, cancer, dermatopathology, laboratory
Lifecyclein_development
UIDf3d21701-f9c3-4cf3-8a81-e05a8908a82f
Language useden
Citeable Identifier1013.1.344
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Microscopic anatomic pathology findings related to melanoma of skin., archetypeConceptComment=null, otherContributors=Koray Atalag, University of Auckland, New Zealand
Matt Cordell, NEHTA, Australia
David Ellis, RCPA, Australia
Heather Leslie, Ocean Informatics, Australia
David McKillop, NEHTA, Australia
Cathy Richardson, NEHTA, Australia, originalLanguage=en, translators=
  • Arabic (Syria): Mona Saleh

    • , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={protocol=[], credentials=[], description=[], ism_transition=[], provider=[], content=[], activities=[], relationships=[], contacts=[], details=[], capabilities=[], context=[], other_participations=[], state=[], events=[], source=[], items=[ResourceSimplifiedHierarchyItem [path=/items[at0001], code=at0001, itemType=CLUSTER, level=1, text=Depth of invasion, description=Depth of tumour invasion. Commonly expressed as the Breslow thickness., comment=Breslow thickness is measured from the top of the granular layer of the epidermis or, if the surface is ulcerated, from the base of the ulcer, to the deepest dermal invasive cell. This should be measured to nearest 0.1mm , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=2, text=Breslow thickness, description=Depth of tumour invasion. Measured to the nearest 0.1mm., comment=The Breslow thickness should be measured in the standard way when there is dermal regression (i.e. dermal regression extending to a greater thickness than the melanoma should not be included in the measurement of Breslow thickness). , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length
    Units: >=0.0 mm
    Limit decimal places: 1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=Comment on invasion measurement, description=Comment on invasion measurement issues or difficulties., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0067], code=at0067, itemType=SLOT, level=1, text=Surgical margins , description=Details of in-situ tumour at the peripheral surgical margins., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.tumour_resection_margins.v1 and specialisations
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0007], code=at0007, itemType=ELEMENT, level=1, text=Clark Level, description=Grading of invasion of the melanoma., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Level I [Melanoma cells are confined to the epidermis (melanoma in situ).]
    • Level II [Melanoma cells invade into but do not fill or expand the papillary (superficial) dermis.]
    • Level III [Melanoma cells fill and expand the papillary dermis with extension of tumour to the papillary-reticular dermal interface.]
    • Level IV [Melanoma cells infiltrate into the reticular dermis.]
    • Level V [Melanoma cells infiltrate into the subcutaneous fat.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0013], code=at0013, itemType=ELEMENT, level=1, text=Mitotic rate per mm2, description=Mitotic rate is a measure of the proliferation status of a cell population, expressed as the number of mitoses per square millimetre., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020], code=at0020, itemType=CLUSTER, level=1, text=Ulceration, description=Findings related to tumour-associated ulceration., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Ulceration, description=Finding of tumour-associated ulceration., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Tumour-associated ulceration is present.]
    • Absent [Tumour associated ulceration is absent.]
    • Indeterminate [Presence of tumour-associated ulceration has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0023], code=at0023, itemType=ELEMENT, level=2, text=Extent of ulceration, description=Maximum diameter of tumour-ulceration visible., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length
    Units: >=0.0 mm, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0125], code=at0125, itemType=SLOT, level=1, text=Lymphovascular invasion, description=Details of lymphovascular invasion., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.tumour_invasion.v1 and specialisations
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0026], code=at0026, itemType=CLUSTER, level=1, text=Microsatellites, description=Findings related to microsatellites., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0026]/items[at0027], code=at0027, itemType=ELEMENT, level=2, text=Microsatellites, description=Finding of microsatellites., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Microsatellites are present.]
    • Absent [Microsatellites are present.]
    • Indeterminate [Presence of microsatellites has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0026]/items[at0028], code=at0028, itemType=ELEMENT, level=2, text=In-transit microsatellites, description=Finding of in-transit microsatellites., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [In-transit microsatellites are present.]
    • Absent [In-transit microsatellites are absent.]
    • Indeterminate [Findings of in-transit microsatellites has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0047], code=at0047, itemType=CLUSTER, level=1, text=Tumour infiltrating lymphocytes, description=Findings related to tumour infiltrating lymphocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0047]/items[at0032], code=at0032, itemType=ELEMENT, level=2, text=Distribution, description=Distribution pattern of tumour infiltrating lymphocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present - Brisk / Diffuse [Tumour infilitrating lyphocytes are present, with infiltration of the entire base of the tumour, or of diffuse permeation of the invasive melanoma.]
    • Present - Nonbrisk / Focal [There are focal areas of tumour infiltrating lymphocytes.]
    • Absent [Tumour infiltrating lymphocytes are absent.]
    • Indeterminate [Presence of tumour infiltrating lymphocytes has not been determined.]
    • Present [Tumour infiltrating lymphocytes are present.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0047]/items[at0083], code=at0083, itemType=ELEMENT, level=2, text=Density, description=Density of tumour infiltrating lymphocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Sparse [Sparse infiltration by lymphocytes.]
    • Dense [Dense infiltration by lymphocytes.]
    • Indeterminate [The density of tumour infiltration has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034], code=at0034, itemType=CLUSTER, level=1, text=Regression, description=Findings related to melanoma regression., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034]/items[at0051], code=at0051, itemType=ELEMENT, level=2, text=Intermediate/late regression, description=Finding of tumour regression., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Absent [Tumour regression is absent.]
    • Present involving less than 75% [Tumour regression is present, involving less than 75% of the tumour.]
    • Present involving 75% or more [Tumour regression is present, involving 75% or more of the tumour.]
    • Present (percentage not determined) [Tumour regression is present. Extent, as a percentage, has not been determined.]
    • Indeterminate [Presence of tumour regression has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034]/items[at0112], code=at0112, itemType=SLOT, level=2, text=Extent of regression, description=Details of extent of regression., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.physical_properties.v1
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034]/items[at0113], code=at0113, itemType=ELEMENT, level=2, text=Marginal clearance of regression, description=Maximum distance of regression from the surgical margin., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length
    Units: >=0.0 mm, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037], code=at0037, itemType=CLUSTER, level=1, text=Desmoplasia, description=Findings related to desmoplasia., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037]/items[at0038], code=at0038, itemType=ELEMENT, level=2, text=Desmoplasia, description=Finding of desmoplasia., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Desmoplasia is present.]
    • Absent [Desmoplasia is absent.]
    • Indeterminate [Presence of desmoplasia has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037]/items[at0039], code=at0039, itemType=ELEMENT, level=2, text=Extent of desmoplasia, description=Extent of desmoplasia, expressed as a percentage of invasive component., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values=
    • Percent
    Numerator: 0.0..100.0
    Denominator: 0.0..100.0
    Assumed value: false
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0100], code=at0100, itemType=CLUSTER, level=1, text=Solar elastosis, description=Findings related to solar elastosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0100]/items[at0101], code=at0101, itemType=ELEMENT, level=2, text=Solar elastosis, description=Finding of solar elastosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Solar elastosis is present.]
    • Absent [Solar elastosis is absent.]
    • Indeterminate [Presence of solar elastosis has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0100]/items[at0105], code=at0105, itemType=ELEMENT, level=2, text=Severity of solar elastosis, description=Severity of solar elastosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0106], code=at0106, itemType=CLUSTER, level=1, text=Predominant cell type(s), description=Findings of predominant cell types., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0106]/items[at0107], code=at0107, itemType=ELEMENT, level=2, text=Predominant cell type, description=Finding of a single predominant tumour cell type., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
    •  Coded Text
      • Spindle cells [Spindle cells represent a predominant cell type.]
      • Epithelioid cells [Epithelioid cells represent a predominant cell type.]
      • Indeterminate [A predominant type of cell has not been determined.]
    •  Text
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0127], code=at0127, itemType=SLOT, level=1, text=Neurotropism, description=Details of neurotropism or perineural invasion., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.tumour_invasion.v1 and specialisations
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0092], code=at0092, itemType=CLUSTER, level=1, text=Associated benign melanocytic lesion(s), description=Findings of any associated benign melanocytic lesions., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0092]/items[at0044], code=at0044, itemType=ELEMENT, level=2, text=Associated benign melanocytic lesion, description=Finding of an associated benign melanocytic lesion., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0091], code=at0091, itemType=CLUSTER, level=1, text=Growth pattern/phase, description=Findings related to growth pattern and growth phase., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0091]/items[at0045], code=at0045, itemType=ELEMENT, level=2, text=Intraepidermal growth pattern, description=Description of the melanoma growth pattern., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
    •  Coded Text
      • Pagetoid [Pagetoid intraepidermal growth pattern.]
      • Lentiginous [Lentiginous intraepidermal growth pattern.]
      • Mixed [Mixed intraepidermal growth pattern.]
      • Indeterminate [The growth pattern has not been determined.]
    •  Text
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0091]/items[at0090], code=at0090, itemType=ELEMENT, level=2, text=Growth phase, description=Description of the melanoma growth phase., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], identities=[], target=[], data=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0001], code=at0001, itemType=CLUSTER, level=1, text=Depth of invasion, description=Depth of tumour invasion. Commonly expressed as the Breslow thickness., comment=Breslow thickness is measured from the top of the granular layer of the epidermis or, if the surface is ulcerated, from the base of the ulcer, to the deepest dermal invasive cell. This should be measured to nearest 0.1mm , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=2, text=Breslow thickness, description=Depth of tumour invasion. Measured to the nearest 0.1mm., comment=The Breslow thickness should be measured in the standard way when there is dermal regression (i.e. dermal regression extending to a greater thickness than the melanoma should not be included in the measurement of Breslow thickness). , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length
    Units: >=0.0 mm
    Limit decimal places: 1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=Comment on invasion measurement, description=Comment on invasion measurement issues or difficulties., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0067], code=at0067, itemType=SLOT, level=1, text=Surgical margins , description=Details of in-situ tumour at the peripheral surgical margins., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.tumour_resection_margins.v1 and specialisations
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0007], code=at0007, itemType=ELEMENT, level=1, text=Clark Level, description=Grading of invasion of the melanoma., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Level I [Melanoma cells are confined to the epidermis (melanoma in situ).]
    • Level II [Melanoma cells invade into but do not fill or expand the papillary (superficial) dermis.]
    • Level III [Melanoma cells fill and expand the papillary dermis with extension of tumour to the papillary-reticular dermal interface.]
    • Level IV [Melanoma cells infiltrate into the reticular dermis.]
    • Level V [Melanoma cells infiltrate into the subcutaneous fat.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0013], code=at0013, itemType=ELEMENT, level=1, text=Mitotic rate per mm2, description=Mitotic rate is a measure of the proliferation status of a cell population, expressed as the number of mitoses per square millimetre., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0

    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020], code=at0020, itemType=CLUSTER, level=1, text=Ulceration, description=Findings related to tumour-associated ulceration., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Ulceration, description=Finding of tumour-associated ulceration., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Tumour-associated ulceration is present.]
    • Absent [Tumour associated ulceration is absent.]
    • Indeterminate [Presence of tumour-associated ulceration has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0020]/items[at0023], code=at0023, itemType=ELEMENT, level=2, text=Extent of ulceration, description=Maximum diameter of tumour-ulceration visible., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length
    Units: >=0.0 mm, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0125], code=at0125, itemType=SLOT, level=1, text=Lymphovascular invasion, description=Details of lymphovascular invasion., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.tumour_invasion.v1 and specialisations
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0026], code=at0026, itemType=CLUSTER, level=1, text=Microsatellites, description=Findings related to microsatellites., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0026]/items[at0027], code=at0027, itemType=ELEMENT, level=2, text=Microsatellites, description=Finding of microsatellites., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Microsatellites are present.]
    • Absent [Microsatellites are present.]
    • Indeterminate [Presence of microsatellites has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0026]/items[at0028], code=at0028, itemType=ELEMENT, level=2, text=In-transit microsatellites, description=Finding of in-transit microsatellites., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [In-transit microsatellites are present.]
    • Absent [In-transit microsatellites are absent.]
    • Indeterminate [Findings of in-transit microsatellites has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0047], code=at0047, itemType=CLUSTER, level=1, text=Tumour infiltrating lymphocytes, description=Findings related to tumour infiltrating lymphocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0047]/items[at0032], code=at0032, itemType=ELEMENT, level=2, text=Distribution, description=Distribution pattern of tumour infiltrating lymphocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present - Brisk / Diffuse [Tumour infilitrating lyphocytes are present, with infiltration of the entire base of the tumour, or of diffuse permeation of the invasive melanoma.]
    • Present - Nonbrisk / Focal [There are focal areas of tumour infiltrating lymphocytes.]
    • Absent [Tumour infiltrating lymphocytes are absent.]
    • Indeterminate [Presence of tumour infiltrating lymphocytes has not been determined.]
    • Present [Tumour infiltrating lymphocytes are present.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0047]/items[at0083], code=at0083, itemType=ELEMENT, level=2, text=Density, description=Density of tumour infiltrating lymphocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Sparse [Sparse infiltration by lymphocytes.]
    • Dense [Dense infiltration by lymphocytes.]
    • Indeterminate [The density of tumour infiltration has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034], code=at0034, itemType=CLUSTER, level=1, text=Regression, description=Findings related to melanoma regression., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034]/items[at0051], code=at0051, itemType=ELEMENT, level=2, text=Intermediate/late regression, description=Finding of tumour regression., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Absent [Tumour regression is absent.]
    • Present involving less than 75% [Tumour regression is present, involving less than 75% of the tumour.]
    • Present involving 75% or more [Tumour regression is present, involving 75% or more of the tumour.]
    • Present (percentage not determined) [Tumour regression is present. Extent, as a percentage, has not been determined.]
    • Indeterminate [Presence of tumour regression has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034]/items[at0112], code=at0112, itemType=SLOT, level=2, text=Extent of regression, description=Details of extent of regression., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.physical_properties.v1
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034]/items[at0113], code=at0113, itemType=ELEMENT, level=2, text=Marginal clearance of regression, description=Maximum distance of regression from the surgical margin., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Length
    Units: >=0.0 mm, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037], code=at0037, itemType=CLUSTER, level=1, text=Desmoplasia, description=Findings related to desmoplasia., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037]/items[at0038], code=at0038, itemType=ELEMENT, level=2, text=Desmoplasia, description=Finding of desmoplasia., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Desmoplasia is present.]
    • Absent [Desmoplasia is absent.]
    • Indeterminate [Presence of desmoplasia has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037]/items[at0039], code=at0039, itemType=ELEMENT, level=2, text=Extent of desmoplasia, description=Extent of desmoplasia, expressed as a percentage of invasive component., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values=
    • Percent
    Numerator: 0.0..100.0
    Denominator: 0.0..100.0
    Assumed value: false
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0100], code=at0100, itemType=CLUSTER, level=1, text=Solar elastosis, description=Findings related to solar elastosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0100]/items[at0101], code=at0101, itemType=ELEMENT, level=2, text=Solar elastosis, description=Finding of solar elastosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Present [Solar elastosis is present.]
    • Absent [Solar elastosis is absent.]
    • Indeterminate [Presence of solar elastosis has not been determined.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0100]/items[at0105], code=at0105, itemType=ELEMENT, level=2, text=Severity of solar elastosis, description=Severity of solar elastosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0106], code=at0106, itemType=CLUSTER, level=1, text=Predominant cell type(s), description=Findings of predominant cell types., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0106]/items[at0107], code=at0107, itemType=ELEMENT, level=2, text=Predominant cell type, description=Finding of a single predominant tumour cell type., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
    •  Coded Text
      • Spindle cells [Spindle cells represent a predominant cell type.]
      • Epithelioid cells [Epithelioid cells represent a predominant cell type.]
      • Indeterminate [A predominant type of cell has not been determined.]
    •  Text
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0127], code=at0127, itemType=SLOT, level=1, text=Neurotropism, description=Details of neurotropism or perineural invasion., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    openEHR-EHR-CLUSTER.tumour_invasion.v1 and specialisations
    Exclude:
    All not explicitly included archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0092], code=at0092, itemType=CLUSTER, level=1, text=Associated benign melanocytic lesion(s), description=Findings of any associated benign melanocytic lesions., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0092]/items[at0044], code=at0044, itemType=ELEMENT, level=2, text=Associated benign melanocytic lesion, description=Finding of an associated benign melanocytic lesion., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0091], code=at0091, itemType=CLUSTER, level=1, text=Growth pattern/phase, description=Findings related to growth pattern and growth phase., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0091]/items[at0045], code=at0045, itemType=ELEMENT, level=2, text=Intraepidermal growth pattern, description=Description of the melanoma growth pattern., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
    •  Coded Text
      • Pagetoid [Pagetoid intraepidermal growth pattern.]
      • Lentiginous [Lentiginous intraepidermal growth pattern.]
      • Mixed [Mixed intraepidermal growth pattern.]
      • Indeterminate [The growth pattern has not been determined.]
    •  Text
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0091]/items[at0090], code=at0090, itemType=ELEMENT, level=2, text=Growth phase, description=Description of the melanoma growth phase., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]