Gladell P. Paner, MD, University of Chicago, Chicago, IL
Rafael E. Jimenez, MD, Mayo Clinic, Rochester, MN
Several tumors and benign lesions from the same GU organ site may exhibit striking resemblances in architecture and cytomorphology, causing diagnostic difficulties and potential pitfalls when presented with the overlapped patterns in routine surgical pathology practice. In recent years, there has been a rise in ancillary modalities such as IHC, FISH and molecular studies that could help facilitate the accurate diagnosis of GU tumors. However, interest in detailed morphologic scrutiny of GU lesions is also being compromised because of the advances and increasing availability of these diagnostic support avenues. Knowledge of key distinguishing features for lesions within these overlapped patterns, including the sometimes subtle or overlooked morphologic clues, may offer the best differential diagnosis -if not the final diagnosis- in given situations. This will allow judicious selection of ancillary tools particularly IHC stains, the use of which is also not free from adding complexities and possible pitfalls in the diagnosis of GU tumors.
Using case-based presentations, this course is designed to provide general pathologists, residents and fellows some practical tips on how to differentiate GU tumors and benign lesions exhibiting overlapping patterns, with emphasis on key H&E features leading to appropriate selection of IHC stains. Specific examples that will be covered include common patterns in renal epithelial neoplasms, papillary and glandular lesions along the GU tract, testicular tumors with solid, glandular or tubular growths, and atypical small and large glands in the prostate.
Upon completion of this educational activity, the participants should be able to: 1) Recognize different tumors and benign lesions in the kidney, prostate, testis and GU tract that may share similar histologic features; 2) Know distinctive morphologic attributes for different lesions within the overlapped patterns and narrow down the differential diagnosis thru alternate pattern-based approach; and 3) Judiciously select IHC stains in different scenarios of overlapped patterns in GU malignant and benign lesions.
Pre-course material will include virtual slides of index cases representing the different scenarios and will be available at the USCAP website. A course syllabus will be distributed to the registrants during the meeting that will cover relevant algorithmic approaches in diagnosis within the different situations presented. After the meeting, all participants will have web access to the PowerPoint materials that will include images highlighting key features of the different GU entities covered.