LONG COURSE Wednesday, March 24, 2010   —  8:00 AM - 5:30 PM Salon 2 ENDOCRINE PATHOLOGY: THYROID AND OTHER ENDOCRINE TUMORS Click the button above to add this event to your Itinerary Planner... COURSE DIRECTORS: Ricardo V. Lloyd, M.D., Ph.D. Mayo Clinic Rochester, MN Yuri E. Nikiforov, M.D., Ph.D. University of Pittsburgh Pittsburgh, PA The aim of the course is to provide practicing pathologists and pathologists in training with a comprehensive update on thyroid and other topics in endocrine pathology through lectures provided by experts on these subjects. The goal of most lectures will be to review practical diagnostic and differential diagnostic issues and to emphasize the role of contemporary ancillary techniques where appropriate. The first half of the course will deal with thyroid lesions, since the vast majority of problems in diagnostic endocrine pathology involve the thyroid gland. This will include presentations on most of the major tumor types involving the thyroid. Since the diagnosis made by the pathologist affects treatment decisions, a presentation of targeted therapy for thyroid tumors is also included. The second part of the course will focus on disorders affecting other endocrine glands including the adrenal cortex and medulla, pancreatic islets, and parathyroid. Controversies involving the role of the neural crest in selected endocrine tumor development will also be discussed. Topics to be covered and objectives for each speaker are listed below. AGENDA 8:00 Welcome and Introduction - Ricardo V. Lloyd, M.D., Ph.D., Department of Pathology, Mayo Clinic, Rochester, MN 8:05 Papillary Thyroid Carcinoma - Virginia LiVolsi, M.D., Hospital of the University of Pennsylvania, Philadelphia, PA To understand the cytologic and histologic nuclear features of papillary thyroid carcinoma and the minimum criteria for diagnosis. To recognize the disorders in which the nuclei mimic those of papillary carcinoma, including thyroiditis, autoimmune hyperthyroidism and other rare lesions. To identify the important variants of papillary thyroid carcinoma, criteria for their diagnosis and their clinical implications. 8:45 Follicular Thyroid Carcinoma - Manuel Sobrinho-Simoes, M.D., Ph.D., Medical Faculty Hospital de S. Joao, Porto, Portugal To review the histologic criteria for diagnosing minimally invasive, angioinvasive and widely invasive follicular carcinoma. To discuss the differential diagnosis of minimally invasive carcinoma vs encapsulated follicular variant of papillary carcinoma and of widely invasive follicular carcinoma vs poorly differentiated carcinoma. To illustrate, where appropriate, the diagnostic and/or prognostic/therapeutic role of special studies including immunohistochemistry and molecular pathology. 9:15 Questions 9:20 Coffee Break, Poster Session V, Exhibits 10:45 Familial Thyroid Cancer - Vania Nosé, M.D., Ph.D., Brigham and Women's Hospital, Boston, MA To discuss differences between sporadic and familial thyroid carcinomas. To discuss familial medullary thyroid carcinoma as a component of familial syndromes including multiple endocrine neoplasia 2A, multiple endocrine neoplasia 2B, familial adenomatous polyposis and phosphatase and tensin homolog deleted on chromosome 10 (PTEN)-hamartoma tumor syndromes. Emphasize the critical role of the pathologist in the identification of these syndromes by recognizing characteristic patterns of thyroid pathology. 11:10 Molecular Analysis of Thyroid Tumors - Yuri Nikiforov, M.D., Ph.D., University of Pittsburgh, Pittsburgh, PA To provide an overview of molecular alterations in thyroid tumors. To discuss specimen requirements for molecular testing in thyroid samples. To discuss the diagnostic and prognostic utility of specific molecular markers in thyroid surgical resections and fine needle aspiration (FNA) samples. 11:40 Questions 11:45 Lunch 1:00 Targeted Therapy for Thyroid Tumors - Steven Sherman, M.D., University of Texas, MD Anderson Cancer Center, Houston, TX To provide an overview of currently available and emerging targeted therapies for thyroid tumors. To review the biological and clinical background for BRAF- and RET-targeted drugs. To discuss the role of pathologic evaluation and molecular testing in selecting patients for targeted therapy and monitoring side effects. 1:30 Introduction to Other Endocrine Tumors - Yuri Nikiforov, M.D., Ph.D., University of Pittsburgh, Pittsburgh, PA 1:35 The neural crest saga and its impact on our perception of neuroendocrine tumors (with a coda) - Juan Rosai, M.D., Centro Consulenze Anatomia Patologica Oncologica, Milan, Italy To describe the role of the neural crest in the development of the vertebrate embryo. To analyze the techniques used to document the neural crest origin of various cell types and the tumors arising from them, with emphasis on LeDouarin's quail-chick chimera model. To summarize the current beliefs concerning neural crest derivatives in the human body, with emphasis on new molecular markers. To briefly raise a phylogenetic consideration as a possible variation on the theme. 2:05 Adrenal Cortical and Medullary Tumors - Ricardo V. Lloyd, M.D., Ph.D., Mayo Clinic, Rochester, MN To review the practical diagnostic approaches to the classification of adrenal cortical and medullary tumors. To discuss the use of ancillary technologies in the differential diagnosis of adrenal cortical and medullary tumors. To discuss molecular findings associated with the development of pheochromocytomas and paragangliomas. 2:35 Questions 2:45 Coffee Break, Poster Session VI, Exhibits 4:15 Pancreatic Endocrine Tumors - Sylvia Asa, M.D., Ph.D., Princess Margaret Hospital, Toronto, Canada To review the critical morphologic and immunohistochemical features involved in the diagnosis of pancreatic endocrine tumors. To understand the molecular basis of familial and sporadic pancreatic endocrine tumors. To identify predictive and prognostic markers and therapeutic options for pancreatic endocrine malignancies. 4:45 Parathyroid Tumors - Ronald DeLellis, M.D., Lifespan Academic Medical Center, RI Hospital, Providence, RI To review the practical diagnostic approaches to the classification of hyperplastic and neoplastic disorders of the parathyroid glands. To review the roles of ancillary technologies (immunohistochemistry and molecular genetic analyses) in the differential diagnosis of hyperparathyroidism. To review contemporary radiological approaches, and the use of intraoperative parathyroid hormone assays in the planning of surgical therapy for patients with hyperparathyroidism. 5:15 Questions and Closing Remarks