2016 Annual Meeting

SC38-Common Diagnostic Dilemmas in Head and Neck Pathology: Pitfalls, Pearls and Clinical Insights

Room CC 611-612, March 18 2016, 1:00pm to 4:30pm


SC38-Common Diagnostic Dilemmas in Head and Neck Pathology: -- Pitfalls, Pearls, and Clinical Insights

Session Credits: 3 CME and 3 SAMs

Qihui Jim Zhai, MD, and John Casler, MD, Departments of Pathology and Otolaryngology, Mayo Clinic, Jacksonville, FL

An experienced otolaryngologist will be partnering with a seasoned pathologist to provide insights on handling practical issues commonly encountered in diagnosing head and neck lesions. This course will highlight surgeons perspectives and pathologists diagnostic pitfalls and pearls. An analytic diagnostic approach will be used to address clinically significant dilemmas and update recently described entities. Appropriate language for conveying key pathologic findings, particularly for equivocal and challenging scenarios, will be illustrated. A case-based and interactive approach between the presenters and attendees will be utilized. This course is designed for pathologists in training, general practicing pathologists in community hospitals, and head and neck pathologists in academic medical centers. Clinical histories, patients symptoms, and electronic images of pathology will be available to preview before the meeting on the USCAP website. After the course, you will be able to review the PowerPoint presented at the meeting on the USCAP website.

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

  1. Classify the histologic variants of squamous cell carcinoma in the head and neck area, emphasizing the HPV-association, HPV/p16 detection methods, with an update on their associated prognostic and therapeutic significance.
  2. Separate a cystic well-differentiated metastatic squamous cell carcinoma in a neck lymph node from a benign cystic lesion such as branchial cleft cyst or an ectopic thymic cyst in the neck;
  3. Apply an algorithmic approach to the classification of salivary gland tumors, using major diagnostic features such as the low power growth patterns, the number of cell types, cytologic atypia, etc. Potential pitfalls such as FNA induced artifacts will be illustrated. Histologic spectrum, immunoprofile, molecular tools, and clinical consequences will be integrated
  4. Separate small blue cell tumors in the head and neck based on morphology, immunoprofile and clinical information
  5. How to utilize the strengths and limitations of thyroid nodule frozen section diagnosis, when to defer to permanent, and when a frozen section diagnosis is contraindicated.

It is critical to consider the previous FNA diagnosis, molecular data, clinical findings, and subsequent surgical procedures that will result from a pathologic diagnosis. Frozen section artifacts, diagnostic pitfalls and pearls will be discussed.


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