2015 Annual Meeting

Long Course- Practical Issues Related to Uterine Pathology

2015 Annual Meeting

Room CC Auditorium, March 25 2015, 8:00am to 5:15pm

Esther Oliva, Marisa Nucci, David C. Wilbur, Brigitte Ronnett, Anais Malpica, Xavier Matias-Guiu, Robert A. Soslow, Glenn McCluggage

Practical Issues Related to Uterine Pathology

Educational Objective

The main goal of this long course is to provide a practical approach to problematic areas and current issues encountered in this important area of surgical pathology. Lectures are intended for general surgical pathologists, advanced pathology residents and those who primarily practice gynecologic pathology. Topics include the diagnosis of benign and malignant cervical glandular lesions with cytologic correlation, diagnosis of endometrioid and non-endometrioid endometrial carcinomas including the potential utility of immunohistochemistry in this setting, staging issues and frozen section analysis for accurate patient treatment, microsatellite instability algorithms (morphologic, immunohistochemical and molecular based) to identify Lynch Syndrome patients, and a practical approach to the diagnosis of endometrial stromal, smooth muscle, and mixed mesenchymal tumors of the uterus including changes in the 2014 WHO classification of these tumors with emphasis on immunohistochemical and molecular tools that can aid in the diagnosis. Upon completion of this educational activity, participants should be able to:

  1. Be aware of the major differential diagnoses and helpful diagnostic features for common entities in uterine pathology
  2. Appropriately diagnose and classify common (and uncommon) neoplasms of the uterus
  3. Recognize immunohistochemical and molecular features associated with specific and newly described entities in both epithelial and mesenchymal categories
  4. Have heightened appreciation of the clinical implications dependent upon the correct diagnosis of uterine tumor subtypes

Session Credits: CME = 5.5 / SAMs = N/A

Agenda

8:00am
Long Course Course Director
Speaker: Marisa Nucci, MD, Brigham and Women?s Hospital and Harvard University, Boston, MA
Access to Handouts
8:00am
Long Course Course Director
Speaker: Esther Oliva, MD, Massachusetts General Hospital, Harvard Medical School, Boston, MA
Access to Handouts
8:00am
Welcome/Introduction
8:05am
Practical Issues Related to Uterine Pathology- In Situ and Invasive Cervical Glandular Lesions and their Benign Mimics: Emphasis on Cytology-Histology Correlation and Interpretive Pitfalls
Speaker: David Wilbur, MD, Massachusetts General Hospital, Boston, MA

Upon completion of this educational activity, participants should be able to:

  1. Recognize the cytologic correlates of in situ and invasive adenocarcinomas including mucinous carcinomas of the cervix
  2. Understand the cytologic and histologic entities that mimic neoplasia and can therefore cause difficulties in differential diagnosis
  3. Appreciate the role of HPV testing in screening for glandular neoplasia of the cervix
Access to Handouts
8:45am
Questions
8:50am
Practical Issues Related to Uterine Pathology- Diagnosis of Malignant Cervical Glandular Lesions
Speaker: Brigitte Ronnett, MD, The Johns Hopkins Hospital, Balitmore, MD

Upon completion of this educational activity, participants should be able to:

  1. Recognize subtle/deceptive patterns of invasion in high-risk HPV-related endocervical glandular proliferations
  2. Distinguish endocervical adenocarcinoma (high-risk HPV-related) from endometrial endometrioid carcinoma
  3. Distinguish benign from well-differentiated malignant mucinous endocervical glandular proliferations (those unrelated to HPV: gastric-type/minimal deviation adenocarcinoma)
Access to Handouts
9:25am
Questions
9:30am
Break/Poster Session
10:30am
Practical Issues Related to Uterine Pathology- How To Approach the Many Faces of Endometrioid Carcinoma
Speaker: Anais Malpica, MD, MD Anderson Cancer Center, Houston, TX

Upon completion of this educational activity, participants should be able to:

  1. Recognize unusual morphologic appearances of endometrioid carcinoma
  2. Be aware of the immunohistochemical spectrum of endometrioid carcinoma
  3. Separate endometrioid carcinoma variants from their mimics
11:25am
Questions
11:30am
Practical Issues Related to Uterine Pathology- Is It, or Is It Not Serous Carcinoma?
Speaker: Xavier Matias-Guiu, MD, Hospital University Arnau de Vilanova, Lleida, Spain

Upon completion of this educational activity, participants should be able to:

  1. Describe the main morphologic spectrum of serous carcinoma
  2. Understand the main differential diagnosis with low and high grade endometrioid carcinomas
  3. Identify the differential features between serous and clear cell carcinoma
Access to Handouts
12:25pm
Questions
12:30pm
Lunch
1:30pm
Practical Issues Related to Uterine Pathology- Staging, Frozen Section, Artifacts and Lynch Syndrome in Endometrial Carcinoma, What Matters?
Speaker: Robert Soslow, MD, Memorial Sloan Kettering Cancer Center, New York, NY

Upon completion of this educational activity, participants should be able to:

  1. Be aware of the FIGO staging criteria for endometrial carcinoma, including its benefits and deficiencies, artifacts and application of the criteria in practical settings
  2. Identify indications for frozen section given a preoperative diagnosis of atypical hyperplasia/EIN or endometrial carcinoma, benefits and deficiencies of this approach, and application in practical settings
  3. Understand the rationale for determining which endometrial cancer patients have Lynch Syndrome and methodology used to determine which endometrial cancer patients are most likely to have Lynch Syndrome
Access to Handouts
2:10pm
Questions
2:15pm
Practical Issues Related to Uterine Pathology- Mixed Epithelial and Mesenchymal Lesions and Their Differential Diagnosis
Speaker: Glenn McCluggage, FRCPath, The Royal Hospitals, Belfast, Ireland

Upon completion of this educational activity, participants should be able to:

  1. To recognize the pathological features of uterine carcinosarcoma and its differential diagnosis
  2. To describe the range of uterine mixed epithelial and mesenchymal lesions with a prominent smooth muscle component
  3. To be aware of criteria for diagnosis and prognostic factors in uterine adenosarcoma and discuss its main differential diagnoses
Access to Handouts
2:55pm
Questions
3:00pm
Break/Poster Session
4:00pm
Practical Issues Related to Uterine Pathology- Endometrial Stromal Neoplasia: From Morphology to Molecular Genetics - An Evolving Entity
Speaker: Marisa Nucci, MD, Brigham and Women?s Hospital and Harvard University, Boston, MA

Upon completion of this educational activity, participants should be able to:

  1. Distinguish between different categories of endometrial stromal neoplasia
  2. Describe the salient histologic features that separate endometrial stromal neoplasia from mimics
  3. Understand the role of ancillary techniques in the diagnosis of endometrial stromal neoplasia
Access to Handouts
4:40pm
Questions
4:45pm
Practical Issues Related to Uterine Pathology- From Banal to Bewildering: The Remarkable Spectrum of Smooth Muscle Neoplasia
Speaker: Esther Oliva, MD, Massachusetts General Hospital, Boston, MA

Upon completion of this educational activity, participants should be able to:

  1. Know criteria that help separate benign from different subtypes of malignant smooth muscle tumors
  2. Be aware of immunohistochemical caveats associated within the category of smooth muscle tumors
  3. Recognize the overlapping and distinguishing features of smooth muscle tumors and PEComa
Access to Handouts
5:25pm
Questions/Adjourn

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