The scope of cytopathology practice has grown increasingly complex in recent years with, for example, exposure to specimen types not previously sampled using cytologic methods and the introduction of new techniques such as endoscopic ultrasound-guided fine needle aspiration. Larger needles used in these procedures are procuring small tissue biopsies that provide material for advanced ancillary studies that are now under the purview of the diagnostic cytopathologist. “Advances in Cytology and Small Biopsies” will provide pathologists and cytotechnologists with a comprehensive overview of and update on diagnostic pathology utilizing a combination of cytology and small biopsy specimens. The emphasis will be on the role of the cytopathologist as a multifaceted pathologist combining light microscopic criteria with ancillary testing, including immunocytochemistry, biochemical testing and genetic analysis as they apply to diagnosis, prognosis and targeted therapy. Advances in automation and standardized terminology reporting will also be presented. The lecture format of our course is supplemented by question and answer sessions. The session at the end of each day will be an educational virtual microscopy case-based presentation focused complimentary topics and quality assurance issues applicable to all aspects of cytopathology. A syllabus of the talks will be provided in an electronic format.
The last edition of the course in 2019 was a significant update to the 29-year history of this course with HMS, including adding an emphasis on small tissue samples. Since 2019, the course has been on hiatus due to the COVID-19 pandemic. With the widespread adoption of virtual meetings, we are taking this opportunity to move to a new virtual distribution format for 2023. The 2023 course will capitalize on the tremendous success of the revamped 2019 course, which sold out 6 weeks in advance of the course dates. The advantage of the livestream format will allow us to greatly expand the registration capacity. We will be using faculty from the three major Harvard teaching hospitals- BWH, MGH, and BIDMC and bring in a world-renowned expert- Dr. Eva Wojcik- our keynote speaker- who will discuss urinary cytopathology and changes to the most widely adopted reporting system for urinary cytopathology- The Paris System 2.0 – that was updated in 2022. We will focus on the role of the cytopathologist in diagnosis using minimally invasive techniques and presenting updates on their role in utilizing ancillary testing for diagnosis, prognosis and targeted therapy for optimal patient care. Finally, we are updating the standardized reporting of pancreaticobiliary lesions with a brief review of the new WHO Reporting System for Pancreaticobiliary Cytology and our “Diagnostic Challenges and Lessons Learned” symposium with digitized virtual glass slides that will be available to registrants in advance of the course. Registrants will be able to submit their diagnosis prior to the case presentation at the meeting where their submissions will drive the discussion and teaching points.
Who Should Attend
- Specialty Physicians
- Primary Care Physicians
- Cytotechnologists
Learning Objectives
Upon completion of this activity, participants will be able to:
- Recognize the full range of diagnostic approaches to cytological and small tissue samples from all body sites.
- Evaluate current and potential applications of automated screening, liquid-based preparation methods, flow cytometry and molecular testing.
- Assess the impact of new technologies on cytology practice.
- Apply current standards for the evaluation and work-up of cytology and small tissue samples for diagnosis, prognosis and targeted therapy.
- Summarize the new standardized terminology and reporting systems for gynecological, pancreaticobiliary, thyroid, salivary gland and urinary cytological specimens.
- Identify diagnostic pitfalls and how to avoid them.
Program
Welcome and Introduction
Martha Bishop Pitman, MD
HSIL and Its Mimics
Vanda Torous, MD
Endocervical-AGCs and Worse
Vanda Torous, MD
Endometrial Cells and Their Mimics
Jeffrey Mito, MD, PhD
Questions
Jeffrey Mito, MD, PhD; Vanda Torous, MD
Break
Primary HPV Screening and Management of Abnormal Screening Results
Sarah Feldman, MD, MPH
The Impact of Primary HPV Screening on the Cytology Laboratory
Jeffrey Mito, MD, PhD
Questions
Jeffrey Mito, MD, PhD; Sarah Feldman, MD, MPH
Lunch
The Elusive Diagnosis of HSIL on the Anal Pap Test
Ivan Chebib, MD
Clinical Management of Patients with Anal Dysplasia
Benjamin Davis, MD
Questions
Ivan Chebib, MD; Benjamin Davis, MD
Break
Application of Practical Informatics to Cytology
Emilio Madrigal, DO
Compliance with CMS Billing
Stephen Black-Schaffer, MD
Questions
Stephen Black-Schaffer, MD; Emilio Madrigal, DO
Break
Challenging Cases and Lessons Learned – Virtual Microscopy 1
Vanda Torous, MD; Caroline Hilburn, MD; Jeffrey Mito, MD, PhD
Updates in Urine Cytology: Paris 2.0
Eva Wojcik, MD
Malignant Effusions: Primary versus Metastatic
Marina Vivero, MD
Break
Pulmonary Cytology: Workup of NSCLC on FNA and Small Biopsy
Paul VanderLaan, MD, PhD
Molecular Testing in Cytology Specimens
Lynette Sholl, MD
Questions
Paul VanderLaan, MD, PhD Lynette Sholl, MD
Lunch
WHO Reporting Systems
Martha Bishop Pitman, MD
Soft Tissue FNA and Small Biopsy – Pt 1
Ivan Chebib, MD
Soft Tissue FNA and Small Biopsy – Pt 2
Vickie Jo, MD
Questions
Ivan Chebib, MD; Vickie Jo, MD
Break
Lymph Node FNA
Amy Ly, MD
Challenging Cases and Lessons Learned – Virtual Microscopy 2
David Hwang, MD; Vickie Jo, MD; Sanhong Yu, MBBS, PhD
The Milan System 2.0
William Faquin, MD, PhD
Unusual Head and Neck Tumors
Kristine Wong, MD
HPV Testing of H&N Squamous Cell Carcinoma
William Faquin, MD, PhD
Questions
William Faquin, MD, PhD; Kristine Wong, MD
Break
Updates to The Bethesda System For Reporting Thyroid Cytopathology
Paul VanderLaan, MD, PhD
The Atypical Thyroid Aspirate
Edmund Cibas, MD
Questions
Edmund Cibas, MD; Paul VanderLaan, MD, PhD
Break for Lunch
Molecular Testing of Thyroid FNAs
Michiya Nishino, MD, PhD
Pancreatic Ductal Carcinoma
Lisa Zhang, MD
Break
Non-Ductal Neoplasms of the Pancreas
Lisa Zhang, MD
Pancreatic Cysts
Martha Bishop Pitman, MD
Questions
Martha Bishop Pitman, MD; Lisa Zhang, MD
Challenges and Lessons Learned – Virtual Microscopy 3
Kristine Wong, MD; Lisa Zhang, MD; Sarah Wu, MD, PhD; Marina Vivero, MD
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