The pathologic evaluation of the lesions of endocrine organs can be a difficult task due to lack of well-defined morphologic criteria and subtle functional alterations leading to subtle or marked cellular atypia. This course will offer practical hints that can aid in the diagnosis of fine-needle aspiration specimens, intraoperative consultations, as well as histology, with conventional histopathology and immunohistochemical and molecular diagnostic tools.

Using a case study approach, this course will illustrate and discuss the following seven diagnostic problem areas: (1) the value and limitations of fine needle aspiration cytology of endocrine tissues with focus on thyroid FNA; (2) the use and abuse of intraoperative consultations, with frozen sections and cytologic touch preparations; (3) the criteria for and the clinical significance of distinguishing endocrine hyperplasia from neoplasia and their clinical consequences; (4) definitions of capsules and capsular invasion as a criterion of malignancy in endocrine tumors; (5) the significance of cellular or architectural atypia, mitoses and necrosis in endocrine tumors; (6) the definition and significance of oncocytic change in endocrine cells, tissues and tumors; and (7) the role of histochemical, immunohistochemical and molecular markers in defining cell differentiation, function and clinical behavior in endocrine lesions.

Upon completion of the course, participants should be able to: 1) Generate a cytologic and histologic differential diagnosis of commonly encountered endocrine lesions of thyroid, parathyroid, adrenal, pituitary gland and diffuse endocrine system; 2) Identify and classify challenging benign and malignant lesions of thyroid, parathyroid, adrenal, pituitary gland and diffuse endocrine system; 3)Recognize the pitfalls in the cytologic and histologic diagnosis of lesions of thyroid, parathyroid, adrenal, pituitary gland and diffuse endocrine system; and 4) Discuss the value of special techniques in the diagnosis of lesions of thyroid, parathyroid, adrenal, pituitary gland and diffuse endocrine system.

The course is designed for advanced residents and general pathologists, as well as subspecialists in cytopathology and endocrine pathology. Pre-registrants will be able to view case histories and electronic images of the study cases, including cytology and corresponding histology, prior to the meeting on the USCAP website. A comprehensive syllabus will be distributed at the course. After the meeting, all course registrants will have access to the PowerPoint presented at the Annual Meeting along with the text portion of the syllabus on the USCAP website.

(LAST SCHEDULED PRESENTATION) This course may be used for CME credits or SAM credits.