SHORT COURSE

Wednesday Afternoon - March 6, 1:30 PM - 5:30 PM




18. Modern Approach to the Diagnosis of Neoplastic Splenic Disorders

Attilio Orazi, MD, FRCPath, Weill Cornell Medical College, New York, NY
Daniel A. Arber MD, Stanford University School of Medicine, Stanford, CA

The recent WHO classification of tumors of hematopoietic and lymphoid tissue has put more emphasis in the accurate identification of specific splenic lymphoid entities (e.g., splenic diffuse red pulp small B cell lymphoma, updated definition for hairy cell leukemia variant). However, due to the uncommon nature of these entities and their extensive morphologic overlap, the differential diagnosis is complicated. Similarly, because of their rare incidence combined with the limited exposure of most pathologists to such cases, most of the T-cell lymphomas and myeloid neoplasms involving the spleen are also perceived as diagnostic difficulties. In addition, the differential diagnosis of pseudotumoral diseases such as sclerosing angiomatoid nodular transformation of the spleen versus splenic hamartoma and other non-hematologic diseases has been object of numerous publications in the last few years.

This course, based on cases retrieved from the two authors' extensive consultation practice, will cover key diagnostic aspects of splenic lymphoid and myeloid neoplasms. Splenic vascular lesions and other non-hematologic conditions including pseudotumoral lesions will also be discussed. An integrated diagnostic approach combining together assessment of morphologic features, immunophenotyping, cytogenetics and molecular genetics will be presented using a case-based and short lecture format. This course is appropriate for practicing anatomic pathologists, surgical pathologists, hematopathologists and all pathology trainees.

Clinical histories with virtual slides of illustrative cases will be provided prior to the meeting. All registrants will receive a course syllabus and the PowerPoint case presentations and the syllabus with a selected bibliography will be available to participants after the meeting on the USCAP website.

Upon completion of this educational activity, the participants should be able to: 1) Describe the subtypes of splenic lymphoid neoplasms included in the 2008 WHO classification of Tumors of the Hematopoietic and Lymphoid Tissues; 2) Recognized splenic manifestation of various myeloid neoplasms; 3) Understand the histopathologic principles used to diagnose different type of non-hematologic disorders occurring in the spleen including selected pseudotumoral lesions; and 4) Demonstrate the advantage of ancillary techniques in this diagnostic setting and learn how their results can be integrated with morphology and clinical data to produce a report useful to clinicians.

(NEW COURSE)