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This course provides a maximum of 18.75 AMA PRA Category 1 Credit(s)™ and 16.75 SAM credit hours.
This advanced course is designed to provide updated pragmatic, problem-solving knowledge for practicing surgical and
cytopathologists who also wish to remain current with the changing trends in cytodiagnosis and laboratory management.
It addresses the resolution of diagnostic pitfalls relative to each of the major organ systems studied by
cytopathology/FNA. A syllabus containing the PowerPoint lecture material will be distributed at the course. Following
the course, these PowerPoint lectures as well as handouts and ancillary materials will be available online for
participants. Above all, this course is intended to provide a pleasant, informal atmosphere for learning as well as
opportunities for 1:1 interaction with the outstanding faculty.
Upon completion of this presentation, participants should be able to:
- Triage cytologic specimens for preliminary and final interpretations for a variety of body sites with an understanding of cytologic limitations and managerial impact.
- Utilize appropriate nomenclature for thyroid, pancreas, and urine cytology.
- Understand the advantages and pitfalls in commonly used and new molecular tests and immunohistochemical stains utilizing cytologic specimens.
- Become well versed in the current guidelines and consensus for Pap tests, HPV testing and management.
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| SATURDAY - January 19th |
| 7:00 - 7:45 | Registration and Continental Breakfast for Registrants |
| 7:45 - 8:00 | Welcome and Announcements |
| 8:00 - 9:00 | Selected Challenges in Salivary Gland Cytopathology - William C. Faquin, MD, PhD
Upon completion of this presentation, participants should be able to:
- Recognize characteristic cytologic features of commonly encountered as well as diagnostically challenging salivary gland tumors.
- Formulate a differential diagnosis and avoid common pitfalls in the diagnosis of salivary gland tumors.
- Effectively use ancillary immunohistochemical and molecular techniques in the cytologic workup of selected salivary gland tumors.
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| 9:00 - 10:00 | Bladder and Kidney Cytology: Tricks to Make It Less Frustrating – Kristen A. Atkins, MD
Upon completion of this presentation, participants should be able to:
- Explain the limitations of urine cytology and what findings can be classified as negative.
- Understand the utility and limitations of FISH, when only a few atypical cells are present in a urine cytology specimen.
- Distinguish normal from low grade neoplasms in kidney aspirates.
- Identify diagnostic pitfalls (normal, malakoplakia, angiomyolipoma) in order to assess adequacy, when faced with preliminary interpretations for kidney FNAs, participants.
- Understand limitations of kidney FNA in assigning subtypes of carcinomas and know whether a core biopsy is indicated.
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| 10:00 - 10:15 | Q&A |
| 10:15 - 11:15 | Respiratory Cytopathology: NSCLC is Not Enough! - Celeste N. Powers, M.D., Ph.D.
Upon completion of this presentation, participants should be able to:
- Present the rationale for the subclassification of NSCLC into squamous cell carcinoma and adenocarcinoma.
- Review the cytologic criteria for the major primary lung carcinomas and the differential diagnoses associated with each carcinoma.
- Illustrate the utility of ancillary studies, especially immunohistochemistry.
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| 11:15 - 12:15 | Lymph Nodes On and Off the Slide - Gilda da Cunha Santos, MD, PhD, FRCPC, FIAC
Upon completion of this presentation, participants should be able to:
- Identify the wide range of neoplastic and non-neoplastic conditions, the advantages, limitations and pitfalls of lymph node FNA.
- Understand the morphological approaches/diagnostic algorithms and specimen triage for ancillary studies such as immunophenotyping, proliferation markers, special stains, cytogenetics (FISH) and molecular studies and their relevance for the diagnosis of lymphoproliferative disorders according to the 2008 World Health Organization (WHO) classification.
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| 12:15 - 1:15 | Practical Aspects for the Procurement and Diagnosis of Mesenchymal Tumors - Kristen A. Atkins, MD
Upon completion of this presentation, participants should be able to:
- Recognize cytologic features of cell differentiation to guide ancillary tests.
- Diagnose mesenchymal neoplasms in solid organs and know what (if any) additional testing is needed.
- Assess a soft tissue neoplasm comfortably with preliminary interpretations, immunohistochemistry and molecular diagnostics particularly with fatty tumors, small round blue cell tumors, and spindle cell lesions.
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| 1:15 | Free Afternoon |
| SUNDAY - January 20th |
| 7:15 - 8:00 | Continental Breakfast for Registrants |
| 8:00 – 8:45 | Infectious Disease in Respiratory Cytopathology - Celeste N. Powers, M.D., Ph.D.
Upon completion of this presentation, participants should be able to:
- Present the advantages and pitfalls associated with the cytologic diagnosis of respiratory pathogens.
- Review the cytologic criteria for microorganisms that are frequently encountered in respiratory infections.
- Focus on the differential diagnosis of fungal organisms, in particular, pathogenic yeast.
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| 8:45 - 9:45 | Utilizing Bethesda Reporting Terminology and Molecular Testing in Thyroid Nodules - William C. Faquin, MD, PhD
Upon completion of this presentation, participants should be able to:
- Understand the Bethesda System for Reporting Thyroid Cytopathology for routine thyroid FNAs.
- Apply the AUS/FLUS category appropriately for indeterminate thyroid FNAs.
- Recognize the implementation, advantages, and limitations of molecular testing for indeterminate thyroid FNA samples.
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| 9:45 - 10:00 | Q&A |
| 10:00 - 11:00 | Thyroid FNA: Unusual Challenges in Common Lesions - William C. Faquin, MD, PhD
Upon completion of this presentation, participants should be able to:
- Apply cytomorphologic criteria in the evaluation and diagnosis of challenging thyroid gland nodules.
- Recognize common problem areas and avoid pitfalls in thyroid cytology.
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| 11:00 - 12:00 | Molecular Diagnostics on Cytologic Specimens - Gilda da Cunha Santos, MD, PhD, FRCPC, FIAC
Upon completion of this presentation, participants should be able to:
- Understand the role and limitations of molecular techniques in providing information as ancillary tests for FNA diagnosis as well as predictive/prognostic data.
- Recognize the types of specimen collection, cytological preparations and their influence in the results of molecular assays as well as the optimal specimen handling/triage for different molecular techniques.
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| 12:00 - 12:30 | LUNCH (Provided by the USCAP) |
| 12:30 - 1:30 | Review of the CAP Gynecologic Cytology Consensus, Diagnostics and Management PART 1 - Kristen A. Atkins, MD
Upon completion of this presentation, participants should be able to:
- Understand the current recommendations for the use on p16 and Ki67 on cervical specimens (cytology and biopsies).
- Recognize pitfalls in using immunohistochemistry in gynecologic biopsies (tubal metaplasia, endometrial glands and lower uterine segment, false positive staining) and how correlating with antecedent Pap tests can assist in diagnosis.
- Explain the current screening and management implications for Pap test diagnoses and HPV testing particularly in special groups such as adolescents and postmenopausal women.
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| 1:30 - 2:30 | Effusion Cytology, Making Sense Out of Scattered Cells - Sharon Mount, MD
Upon completion of this presentation, participants should be able to:
- Recognize the benign and common malignant lesions involving serous cavities and avoid diagnostic pitfalls in effusion cytology cases.
- Understand the changing clinical significance of malignant diagnoses made from effusion cytology specimens.
- Triage effusion specimens for ancillary studies including flow cytometry and cell block preparations.
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| 2:30 - 3:30 | Pancreatic FNA: Classic Cytologic Principles - Edward Stelow, MD
Upon completion of this presentation, participants should be able to:
- Render appropriate preliminary interpretations on pancreatic aspirates as well as provide triage for the samples, given a clinical and cytologic scenario.
- Distinguish pancreatic neuroendocrine tumors, acinar cell carcinoma, and solid psuedopapillary neoplasm with cytology and immunohistochemistry, given an aspirate of monomorphic cells in a pancreatic aspirate.
- Identify the cytologic features that best allow for the distinction of mucinous pancreatic cysts from other pancreatic cysts.
- Understand the importance and limitations of mucinous lesions in aspirates, as well as the cytopathologists role in patient triage.
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| 3:30 - 3:45 | BREAK |
| 3:45 - 4:45 | Pancreatobiliary Cytology: Advanced Techniques and Challenging Diagnoses - Edward Stelow, MD
Upon completion of this presentation, participants should be able to:
- Understand the use of various ancillary testing methods for the diagnosis of pancreatic malignancy and cystic mucinous neoplasia.
- Describe features to support a reactive or malignant process and the most common pitfalls in this distinction, given a setting of chronic pancreatitis and a mass or cyst lesion.
- Describe the cytologic features found with aspirates of uncommon solid and cystic pancreatic lesions, such as lymphoepithelial cyst, autoimmune pancreatitis, and metastases.
- Understand when pancreatic neoplasia is a clue to a cancer syndrome.
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| 4:45 – 5:45 | Review of the CAP Gynecologic Cytology Consensus, Diagnostics and Management, Part II - Kristen A. Atkins, MD
Upon completion of this presentation, participants should be able to:
- Apply the common mistakes on CAP gynecologic in service tests to their own practice, by using CAP tests results.
- Understand the necessity of validation on any new HPV test being offered in their laboratory.
- Explain new cytology- specific additions to the checklist for laboratory inspections.
- Evaluate American and European trials, screening effectiveness and know what possibilities may be encountered in the future (PCR based HPV testing, self-collection).
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| 6:00 – 7:30 | Reception for Registrants and Accompanying Persons |
| MONDAY - January 21st |
| 7:15 - 8:00 | Continental Breakfast for Registrants |
| 8:00 - 9:00 | Gynecologic Cytology: Managerial and Histologic Implications of Atypical Glandular Lesions - Sharon Mount, MD
Upon completion of this presentation, participants should be able to:
- Understand the clinical follow-up algorithms as proposed by the ASCCP 2006 as they pertain to AGC diagnoses.
- Correlate AGC Pap Test diagnoses with expected and unexpected histologic findings.
- Consider the possible future role of HPV testing as it applies to AGC diagnosis.
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| 9:00 - 10:00 | Navigating Challenging Liver Aspirates and Tiny Core Biopsies - Edward Stelow, MD
Upon completion of this presentation, participants should be able to:
- Understand the use of preliminary interpretation with hepatic aspirates and when to request a core biopsy.
- Recognize the unique and shared features on aspiration cytology of dominant regenerative nodule in cirrhosis, other benign hepatocytic lesions and well-differentiated hepatocellular carcinoma.
- Identify how to approach bland glandular, epithelioid, and hepatocyte-like cells in an aspirate of a mass lesion and will be able to identify features that support cholangiocarcinoma, hepatocellular carcinoma, metastatic melanoma, metastatic neuroendocrine carcinoma, etc.
- Understand the use of ancillary methods for distinguishing benign and malignant lesions with hepatic aspirates.
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| 10:00 - 10:15 | Q&A |
| 10:15 - 11:15 | FNA Metastasis of Unknown Primary, Making the Most Out of Uncertainty - Sharon Mount, MD
Upon completion of this presentation, participants should be able to:
- Realize the necessity of obtaining adequate clinical and pathologic patient history from all available sources.
- Recognize the importance and limitations of immunocytochemistry in the work up of an unknown primary.
- Anticipate the need for ancillary studies and appropriately triage the specimen at the time of the procedure with attention to the possible contribution of molecular studies in treatment and prognosis.
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| 11:15 – 12:30 | Pearls in Cytology - Kristen A. Atkins, MD
Upon completion of this presentation, participants should be able to:
- Given a clinical scenario and cytologic image, participants will be able to apply the information presented in each session to a challenging case.
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