2017 Annual Meeting
SC60-Surgical Pathology and Cytopathology of the Pancreas and Ampulla
March 8 2017, 8:00am to 12:00pm
SC60Surgical Pathology and Cytopathology of the Pancreas and Ampulla
Session Credits: 3 CME and 3 SAMs
Faculty: N. Volkan Adsay, M.D.; Emory University Hospital, Atlanta, GA, Olca Basturk, M.D. Memorial Sloan Kettering Cancer Center, New York, NY and Michelle Dian Reid, M.D., M.Sc.; Emory University Hospital, Atlanta, GA
Recent advances in imaging and surgical techniques have made the pancreas and ampulla infinitely more accessible to sampling and resection. As a result, pancreatobiliary tract FNAs, biopsies and associated resections are no longer seen only at major academic centers but at smaller institutions and private practice. Evolving research in the field has also led to changes in terminology, classification, management and newly described site-specific entities, many of which were recently characterized (including intraductal papillary mucinous neoplasms (IPMN), intraductal tubulo-papillary neoplasm (ITPN), intra-ampullary papillary-tubular neoplasm (IAPN), as well as pancreatic neuroendocrine tumors.
Innumerable diagnostic challenges in these sites arise because of their anatomic complexity and inflammation and stent-related alterations, which are a source of indecision and diagnostic errors among surgical and cytopathologists. Molecular diagnostics have improved our diagnostic accuracy of cystic pancreatic neoplasms (IPMNs, mucinous cystic neoplasms, serous neoplasms, solid-pseudopapillary neoplasm).
This course will provide an overview of practical and applicable clues to the histologic and cytologic diagnosis of solid and cystic pancreatic as well as ampullary neoplasms, with an algorithmic approach to differential diagnosis that the target audience (of surgical, GI and cyto-pathologists as well as pathologists-in-training) can then apply in daily practice.
Upon completion of this educational activity, participants should be able to:
(1) Recognize key gross, histologic, and cytologic features that distinguish cystic and solid pancreatic neoplasms (including ductal adenocarcinoma and PanNETs) from mimics
(2) Understand FNA limitations in evaluating pancreatic cysts, and frozen section limitations in margin assessment of pancreatic intraductal neoplasia
(3) Dissect and sample Whipples to ensure accurate tumor identification while maximizing nodal yield
(4) Appropriately sample and classify ampullary and peri-ampullary neoplasms using a site-specific classification system.