2016 Annual Meeting

American Society for Cytopathology

Room CC Ballroom 6 C, March 13 2016, 7:30pm to 10:30pm

Description

American Society for Cytopathology
Everything That Shines Ain't Always Gonna Be Gold - Insights into Cytology/Histology Correlations

Credits: 3 CME and 3 SAMs

Sunday, March 13, 7:30 PM - 10:30 PM

Moderator: Eva M. Wojcik, MD, Loyola University Medical Center, Maywood, IL

The ASC’s diverse membership shares a vision of education, research, and continuous improvement in the standards and quality of patient care. From the diverse membership, the educational committees of the ASC determine a set of educational standards that guide the committees as to the educational needs of the cytopathology community. Evaluation of data from prior meetings and advances in medicine related to pathology/cytopathology are important sources of information used by the education committees to plan ASC educational activities. The programs are reviewed and approved by the ASC Executive Board.

The session is designed for Practicing pathologists, fellows and residents in training.

Correlation of cytology findings with histologic biopsies is essential for successful quality assurance/improvement programs. Traditionally, the diagnosis rendered on histologic specimens has been considered the gold standard, against which cytologic interpretations are measured. In reality, both types of material are often complementary and, in many cases, different features necessary to make a correct diagnosis are present only on one type of preparation. It is imperative to convey this information to clinicians who usually consider the results of histologic examination as final. Currently, with an explosion of personalized approach to diagnostic medicine, less and less material is available for diagnostic purposes. It is important for pathologists to be comfortable with an evaluation of both cytology and histology specimens. It is essential to understand specific limitations for each type of specimens, particularly in regards of how precise diagnosis can be made on cytology and small histological material. In addition, it is important to realize that interpretation of adjuvant, particularly immunohistochemical, studies on cytology and histology material may be different.

New classification systems and revision of the existing classification systems for surgical pathology diagnoses necessitate that the cytopathologist adapt accordingly their diagnostic terminology. It can be challenging when the revised surgical pathology terminology reclassifies neoplasms previously diagnosed as malignant to now benign neoplasms--or the other way around. The question arises how to avoid over diagnosis of malignancy in thyroid FNA specimens if most cases of encapsulated “follicular variant of papillary carcinoma” of the thyroid are diagnosed as “Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT).”

In few areas is fine needle aspiration as controversial as in the diagnosis and management of salivary gland lesions; while some head and neck surgeons use it routinely, others deny its usefulness. This may, in part, be due to a lack of a practical terminology and classification system for salivary gland aspirates that is useful for clinical decision-making. A new, clinically-oriented classification system and reporting terminology specifically geared to fine needle aspiration cytology are being proposed.

Soft tissue tumors are the bane of both the surgical pathologist and the cytopathologist. An aspirate showing predominantly spindle cells inspires well-founded fear in most pathologists; however, once the initial angst is overcome, careful review of the morphology, coupled with judicious use of immunohistochemistry and molecular tests is frequently helpful to establish a diagnosis, or at least give enough information to orient further management of the patient.

Gynecologic cytopathology remains one of the most difficult areas of cytopathology. Cytology- histology correlation is a requirement. Many factors influence this correlation. Some are intrinsic to colposcopy, others relate to inter-observer variability and still others pertain to the approaches that can be taken at the time of biopsy/LEEP sign out, including ancillary testing. Together, these approaches can serve to refine interpretations and possibly improve the correlation.

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

  1. Incorporate the new developments in thyroid pathology in their reporting of thyroid fine needle aspirates
  2. Understand the need and rationale of a new standardized cytology reporting of salivary gland fine needle aspirates
  3. Determine which type(s) of specimens should be sent for molecular testing in lung and mediastinal biopsies and FNAs
  4. Use an algorithmic diagnostic approach to spindle cell aspirates and determine what ancillary tests should be used
  5. Understand the limitations of GYN cyto-histology correlations and practical approaches for improvement

 

7:30 PM Welcome and Introduction
Eva M. Wojcik, MD, Loyola University Medical Center, Maywood, IL
7:45 PM The New Diagnostic Paradigms in Thyroid Surgical Pathology and Effects on Reporting of Thyroid Fine-Needle Aspiration Specimens.
Zubair W. Baloch, MD, PhD, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
8:10 PM Time to Standardize the Cytology Reporting of Salivary Glands - Introduction of the Milan System
William Faquin, MD, PhD, Massachusetts General Hospital, Boston, MA
8:35 PM In an Era of Personalized Approach to Lung Cancer - -Which Type of Specimen Rules Supreme?
Swati Mehrotra, MD, Loyola University Medical Center, Maywood, IL
9:00 PM Everything is Spindle - How Far Can We Go With Limited Material?
Paul Wakely, Jr., MD, The Ohio State University Wexner Medical Center, Columbus, OH
9:25 PM Cytology/Biopsy/LEEP Correlation - Practical Considerations and Approaches
Fadi W. Abdul-Karim, MD, Med, Cleveland Clinic Lerner College of Medicine and Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland, OH
9:50 PM Glandular Lesions on Pap - Still Difficult After All These Years
Dina Mody, MD, The Methodist Hospital, Houston, TX
10:15 PM Q & A

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