Past presidents of the ASC will give 90-minute educational or motivational seminars to groups of 20 attendees. The basic theme is to let ASC members interact with our nationally recognized leaders in an informal “close” atmosphere and also to recognize and honor the past presidents for their years of mentorship and education.
Friday | Tuesday
| Friday, November 4, 2011 |
7:00 pm - 8:30 pm
| Presidents' Rounds #1
Credit Hours:1.5 CME/CMLE
What Can Cervical Cancer Cases in Previously Screened Women Teach Us About Cervical Carcinogenesis and the Limitations of Various Methods of Cervical Screening and Cervical Cancer Prevention?
R. Marshall Austin, MD, PhD
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Educational Objectives:
1. Understand that glandular cervical cancers are more difficult to sample, identify, and prevent than more common squamous cervical cancers
2. Understand that cervical cancers in younger women are significantly more difficult to prevent than more slowly developing cervical cancers which predominate in older women
3. Understand how HPV testing can be a useful adjunct to cytology screening in prventing cervical cancers in screened women
Papanicolaou testing is the most effective cancer prevention method in medical history. Nevertheless, significant numbers of cervical cancers continue to arise in screened women. Disproportionately, cervical cancers in screened women are glandular cervical cancers and more rapidly progressive cervical cancers in younger women. Some squamous carcinomas do occur in screened older women. Since many CIN2/3 lesions regress, particularly in younger women, and most CIN2/3 lesions do not progress to cervical cancer even during decades long follow-up, cases of cervical cancer in screened women offer a unique potential retrospective opportunity for educational review of proven cervical cancer precursor lesions. Case histories will review common patterns of often difficult cytology findings in these cases. The utility and limitations of HPV testing will also be explored.
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7:00 pm - 8:30 pm
 | Presidents' Rounds #2
Credit Hours:1.5 CME/CMLE
Diagnostic Difficulties in Pulmonary Cytology and Proper Use of Ancillary Tests
Hormoz Ehya, MD
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Educational Objectives:
1. Recognize morphologic features helpful in the differential diagnosis of reactive conditions versus malignant neoplasms
2. Become familiar with difficulties in classification of lung tumors and sensible use of immunocytochemical stains
3. Be cognizant of the differential diagnosis of small cell carcinoma and its mimics
Major diagnostic pitfalls in pulmonary cytology include the differential diagnosis of benign/reactive conditions versus carcinoma and classification of neoplasms. While in the past the distinction between small cell and non-small cell carcinomas was adequate for therapeutic purposes, the new targeted therapies require further classification of non-small cell carcinoma into squamous carcinoma and adenocarcinoma. Improved survival in cancer patients has led to the increased occurrence of second and third primaries, necessitating the use of immunocytochemical stains to determine the primary source. Furthermore, the increasing need for molecular studies mandates prudent use of immunostains in order to conserve tissue. In this session, fine needle aspirates and bronchoscopic specimens from various conditions are presented with an emphasis on the differential diagnosis of reactive bronchial or alveolar cells versus carcinoma, classification of small cell neoplasms (basaloid squamous carcinoma versus small cell carcinoma, versus other neuroendocrine neoplasms), poorly differentiated non-small cell carcinomas (squamous versus adenocarcinoma) and common metastatic tumors versus primary lung cancer.
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7:00 pm - 8:30 pm
 | Presidents' Rounds #3
Credit Hours:1.5 CME/CMLE
The Quality Pap Test: Reflections on Efforts by Professional Societies and the Government since 1988
Diane D. Davey, MD
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Educational Objectives:
1. Discuss the early and ongoing efforts of professional societies to address CLIA '88 regulations, proficiency testing, and the Pap litigation crisis by means of interlaboratory comparison programs, consensus conferences, and guidelines
2. Discuss the challenges of FDA regulation of cytology devices, and describe the impact of society guidance documents on FDA policies
3. List recommendations for improving cervical cytology quality that resulted from the CAP/CDC Consensus Conference and illustrate these using specific problematic Pap tests
The past 23 years represent a fascinating era in efforts to improve Pap test quality. The CAP Cytopathology Committee, formed to address the challenges of CLIA '88, launched various interlaboratory comparison programs. For the first time, the FDA approved devices involved in traditional anatomic pathology testing. In additional to the Bethesda terminology, numerous guidelines have been written by professional societies that encompass patient management, litigation, and quality improvement. The 2011 CAP/CDC Gyn Consensus Conference proceedings will also be discussed. As a charter member of the CAP Cytopathology Committee, an FDA panel member, and a co-author of numerous Pap guidelines, Dr. Davey offers her reflections on this era. Specific challenging Pap tests will also be illustrated.
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