Cholecystectomies and ampullary biopsies are common specimens in general surgical pathology practice. Dysplasias and carcinomas of the gallbladder are typically unexpected findings and can be difficult to distinguish from reactive atypia. In the ampulla, active chronic inflammation can cause severe reactive atypia that is a frequent mimic of adenoma or dysplasia. While pancreatectomies and pancreatic biopsies are less frequently encountered, the relatively recent recognition of autoimmune pancreatitis as an inflammatory mimic of pancreatic carcinoma has made pre-operative diagnosis of this condition more important and biopsies more frequent. For true neoplasms in all three sites, choosing proper staging criteria and determining margins of importance can be challenging.

This course will use a case-based format to explore these difficult diagnoses and dilemmas in pancreaticobiliary pathology. A responsive keypad system will be utilized for interactive audience participation. Upon completion of the course, participants should be able to: 1) distinguish reactive atypia from dysplasia in the gallbladder; 2) recognize benign lesions of the gallbladder (dysplasia confined to Rokitansky-Aschoff sinuses, adenomyoma, florid hyperplasia of Luschka's ducts) and separate them from invasive carcinoma; 3) distinguish inflammatory atypia of the ampulla from adenoma/dysplasia, and separate adenomatous epithelium involving deep ampullary glands from well-differentiated adenocarcinoma; 4) explain autoimmune pancreatitis and its diagnosis on biopsies, and other reactive/inflammatory mimics of pancreatic carcinoma; and 5) effectively apply the current staging systems for carcinomas of the gallbladder, ampulla, and pancreas.

This course is intended for both practicing surgical pathologists and pathologists in training. Pre-registrants will be able to view the case histories, virtual slides and still images 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 presentation and the text portion of the syllabus on the USCAP website.

This course may be used for CME credits or SAM credits.