|November 12, 2010|
|1:00 pm - 2:30 pm||Video Microscopy Tutorial #1
Utility of Immunocytochemical Stains in Diagnostic Cytology
Srinivas Mandavilli, M.D.
1) Understand the utility of and recognize pitfalls of immunocytochemical stains in diagnostic cytology
2) Learn the applications of the more recently described immunocytochemical markers in diagnosis of tumors
3) Provide the basis to select a judicious panel of immunocytochemical stains in the work-up of cases with a difficult and wide differential diagnosis
The cases presented along with the discussion will illustrate applications of immunocytochemistry in diagnostic cytopathology. Using a case-based format, the utility of a variety of immunocytochemical markers in the work-up of a variety of tumors will be presented. The selection of an appropriate panel of immunocytochemical stains in individual cases will be discussed. The role of more recently described immunocytochemical markers and how they could be incorporated to a panel of more established markers will also be discussed.
|1:00 pm - 2:30 pm ||Video Microscopy Tutorial #2
Cytology of the Respiratory Tract: With Emphasis on Differential Diagnoses and Pitfalls
Manon Auger, M.D.
1) To provide a structured approach for the diagnostic interpretation of various cytological specimens from the respiratory tract with an emphasis provided on resolution of differential diagnoses
2) To illustrate a wide range of cytological presentations of benign and malignant pulmonary lesions
3) To familiarize the registrants with diagnostic pitfalls
This tutorial will include a concise didactic portion followed by a practical video microscopic slide session, both focusing on the demonstration of the spectrum of cytological features/variants of specific benign and malignant pulmonary lesions. Emphasis will be placed on the recognition of diagnostic pitfalls and on approaches to resolve differential diagnostic dilemmas. Histological correlation will be amply illustrated. Diagnostic limitations of respiratory tract cytology will be discussed.
|1:00 pm - 2:30 pm||Video Microscopy Tutorial #3
The Asylum of ASC-US
Daniel F. I. Kurtycz, M.D.
1) To discuss the problem of analytical resolution in clinical laboratory testing
2) To review processes that worsen morphologic resolution including: metaplasia, degeneration, inflammation, repair and other forms of cellular stimulation
3) To show that the work of important authors of the past can bring clarity to what continues to be a source of insecurity
4) To improve efficiency of daily work-life in gynecologic cytology by attempting to set boundaries on the ASC-US category
In cervical cytology the “gray zone” of Atypical Cells of Uncertain Significance (ASC-US) continues to be a source of frustration for cytologists, clinicians and patients. It is well known that a strictly morphologic analysis cannot totally resolve the diseased and the non-diseased population when evaluating the cytology of the uterine cervix for neoplasia. ASC-US has shown itself to have reproducibility problems between institutions, within institutions and within a given observer. Nonetheless, there are basic principles in the evaluation of cervical cytology given to us by historical figures such as Dr. Stanley Patten and John Frost that can let us know when we are in the realm of ASC-US. Principles that can tell us “when to make the call” and move on to the next case. In this Video-Microscopic Tutorial we intend to talk about many of those principles and to display numerous examples. Patterns and themes of cellular alterations that interfere with our ability to bring clarity to the Pap test will be discussed. We intend to deal with the pain of metaplasia, the perversity of parakeratosis, the problem of degeneration, and enhance our efficiency.
|3:30 pm - 5:00 pm||Video Microscopy Tutorial #4 - CANCELED
Diagnostic Pitfalls in Serous Effusion Cytology
Walid E. Khalbuss, M.D., Ph.D.
1) To review selected serous effusion cases with emphasis on potential diagnostic pitfalls and the cytologic approach to making diagnoses in fluid cytology
2) To review selected challenging and unusual cases in body cavity fluid cytology
This tutorial offers a case-based approach to serous effusion cytology. The course will begin with a short didactic presentation on the diagnostic challenges in fluid cytology and how to distinguishing reactive mesothelial cells from malignant mesothelioma and metastatic malignancies such as carcinomas, lymphomas, and other unusual/rare entities in effusion cytology (sarcoma, germ cell tumor, neuroendocrine carcinoma, granulosa cell tumor, and adenoid cystic carcinoma). The focus will be on the approach to making diagnoses in body cavity fluid cytology and to recognizing the diagnostic pitfalls. Then, a variety of cases will be discussed using an interactive approach through the use of video microscopy. The potential pitfalls and the role of ancillary studies will also be discussed.
|3:30 pm - 5:00 pm||Video Microscopy Tutorial #5
Cytologic Diagnosis of Lymphomas: Impact of the 2008 WHO Lymphoma Classification
Oscar Lin, M.D., Ph.D.
1) Demonstrate how to make a diagnosis of a lymphoproliferative lesion using cytologic material in the context of the 2008 WHO lymphoma classification
2) Provide an update on the new entities recognized in the 2008 WHO lymphoma classification and their cytomorphologic presentation
The use of cytology specimens, particularly FNAs, to diagnose lymphoproliferative lesions continue to grow as more studies can be performed with less material. The 2008 WHO lymphoma classification has introduced several new entities with special attention given to site and age. Some of the newly recognized entities have unique characteristics that might make an accurate cytology diagnosis difficult even with the use of the usual immunocytochemical or flow cytometry markers. The tutorial will provide useful information how to make the diagnosis of lymphoid lesions in the context of the 2008 WHO lymphoma classification and how to address the newly recognized entities. Special attention will be given to potential pitfalls in the diagnosis of the lymphomas with unique phenotype.
|3:30 pm - 5:00 pm ||Video Microscopy Tutorial #6
EUS-FNA of Pancreas: A Million Dollar, Easy to Follow Morphology Based Practical Algorithmic Approach to Different Diseases
Darshana N. Jhala, M.D., B.Mus.
1) Able to approach EUS-FNA pancreatic specimens methodically and use the practical algorithm to arrive at a diagnosis
2) Able to learn and apply the use of ancillary studies including immunohistochemistry, flow cytometry and electron microscopy
3) Common and uncommon diseases including pancreatic cancer, neuroendocrine tumor, cystic lesions including mucinous cystadenoma, IPMN, chronic pancreatitis, autoimmune pancreatitis, etc., will be discussed
4) Able to learn important pertinent ultrasound findings to correlate EUS images with EUS-FNA findings
5) Able to learn the usefulness of a combined EUS-FNA and EUS guided Tru-cut biopsy in pancreatic diseases.
Pancreatic cancer is among the top 10 leading causes of cancer-associated deaths in the United States. It is reported that resection of early (size <3.0cm) organ-confined tumors provide significantly improved patient survival. Endoscopic ultrasound (EUS) is superior to CT scans and MRI in detecting smaller pancreatic lesions. While imaging studies are important to detect the lesion, tissue diagnosis still remains the gold standard. The success of EUS-FNA in diagnosing pancreatic lesions has changed the practice for obtaining pre-operative diagnosis. Intrinsically, the EUS-FNA specimens from the pancreas are difficult to approach and interpret. A simple morphology-based algorithm to approach these specimens would be of immense help, which has not been previously described in the literature. During this course, a morphology-based practical algorithm will be used to arrive at the diagnosis for common and uncommon pancreatic diseases.