Companion Society Meetings

Papanicolaou Society of Cytopathology

Cytopathology of the Head and Neck: It's More Than Just the Thyroid Gland

Saturday, March 17, 2018, 7:00 - 10:00 PM

Session Credits:

3 CME and 3 SAMs


Lester J. Layfield, MD, University of Missouri, Columbia, MO

Course Description:

The Papanicolaou Society of Cytopathology's 2018 Scientific Session will focus on the cytology of non-thyroid head and neck lesions. Four presentations will be given covering issues of interpretation of salivary gland fine-needle aspiration specimens, risk assessment for salivary gland lesions on FNA and small biopsy specimens, discussion of diagnostic approach and differential diagnoses for cystic lesions of the head and neck and the utility of HPV and p16 testing of cytologic specimens.

Fine-needle aspiration of the salivary glands has become a topic of increased interest secondary to the development of the Milan System for Reporting Salivary Gland Cytology. While this system establishes a framework with six categories for reporting diagnoses of salivary gland lesions, discussion of a pattern-based approach for identification of a wide variety of salivary gland neoplastic and non-neoplastic lesions is helpful for both experienced cytopathologists and the practicing pathologist with little focused experience in salivary gland FNA interpretation. Dr. Rossi will present a pattern-based approach to the diagnosis of salivary gland lesions. This approach analyzes the appearance of background materials (stroma and mucin), cell-cell interactions including distribution of cells into clusters, sheets and groups as well as the distribution of individual cells. The diagnostic value of the morphologic appearance of individual cells will also be discussed. The importance of combining a global approach including low power analysis to the diagnosis of salivary gland lesions will be highlighted.

Dr. Seethala will continue the discussion of salivary gland FNA and expand the topic to small biopsy specimens. The nature of FNA and small core biopsy specimens generally precludes evaluation of the presence or absence of a capsule as well as gross architectural pattern. His presentation will address malignancy risk for individual diagnoses as well as categorical diagnoses as suggested by the Milan System for Reporting Salivary Gland Cytology.

Dr. Baloch will discuss the cytology of the cystic lesions occurring within the head and neck area. This is a complex topic with accurate diagnosis having significant clinical impact. Cystic lesions within the head and neck include thyroglossal duct cysts, parathyroid cysts, branchial cleft cysts and cystic metastatic thyroid carcinomas and squamous cell carcinomas. Each of these lesions presents significant diagnostic challenges with clinical relevance. Clinical features including location, patient age, smoking status and HPV status are all helpful items of information for accurate diagnosis. Important differential diagnoses including the distinction of branchial cleft cysts from cystic squamous cell carcinomas as well as the importance of recognizing thyroglossal duct cysts and other cystic embryological remnants will be discussed.

Dr. Bishop will discuss the broad topic of HPV and p16 testing with its implications for cytologic diagnosis and patient management. Testing methodologies for HPV related disease will be discussed. The prognostic impact and management/therapeutic implications of HPV positive squamous cell carcinomas will be highlighted.


7:00 PM Introduction
Lester J. Layfield, MD, University of Missouri, Columbia, MO
7:15 AM Diagnosis of Salivary Gland Tumors: A Cellular and a Pattern Based Approach
E. Diana Rossi, MD, Catholic University of Rome, Rome, Italy
7:50 PM Cystic Lesions of the Head and Neck: A Cytopathologist's Perspective
Zubair Baloch, MD, PhD, University of Pennsylvania, Philadelphia, PA
8:25 PM HPV and p16 Testing: Implications for Head and Neck Cytopathology
Justin Bishop, MD, University of Texas Southwestern Medical Center, Dallas, TX
9:00 PM Defining Risk Assessment of Salivary Gland Lesions on FNA and Small Biopsy Specimens
Raja R. Seethala, MD, University of Pittsburgh, Pittsburgh, PA


Continuing Medical Education and Maintenance of Certification

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The United States and Canadian Academy of Pathology and Papanicolaou Society of Cytopathology. The United States and Canadian Academy of Pathology is accredited by the ACCME to provide continuing medical education for physicians.

The United States and Canadian Academy of Pathology designates this live activity for a maximum of
3 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The USCAP is approved by the American Board of Pathology (ABP) to offer Self-Assessment credits (SAMs) for the purpose of meeting the ABP requirements for Maintenance of Certification (MOC). Physicians must take and pass the post-test in order to claim SAMs credit.

Physicians can earn a maximum of 3 SAM credit hours.


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