Three Sessions You Don’t Want to Miss at ASCP

The ASCP 2017 Annual Meeting will be hosted at the Hyatt Regency Chicago from September 6–8. Visit Cleveland Clinic Laboratories at Booth 615 to meet and talk with staff and representatives, or attend any of the staff presentations listed below.

Challenging Diagnoses in Breast Pathology: What to Do When Your Case is Not the Classic Textbook Example

Benjamin Calhoun, MD, PhD
Director, Breast Pathology, Cleveland Clinic Pathology & Laboratory Medicine Institute
Sept. 6, 8:00-9:15 am and 1:00–2:30 pm

Breast pathology accounts for a significant proportion of the cases seen by practicing pathologists. Several well-illustrated breast pathology textbooks serve as valuable resources for diagnosing challenging cases. But, some areas of breast pathology, especially in limited and/or fragmented core biopsies, may be difficult to diagnose by matching the histologic appearance on the slide to “textbook” examples. The entire histologic continuum may not be shown and cases near the borders of diagnostic categories are not selected for illustration. Frequently encountered histologic entities posing these challenges include columnar cell lesions and flat epithelial atypia (FEA), spindle cell lesions, papillary lesions, fibroepithelial lesions, vascular lesions and metastases that may mimic primary breast carcinoma. This course will provide a practical approach to the evaluation of these challenging lesions by relying on distinguishing histologic features, the appropriate use of immunohistochemistry, and refining the differential diagnosis with clinical and radiologic correlation. Advances in the molecular classification of these lesions will be highlighted when relevant and clinical management will be discussed to prepare pathologists for the essential role they play in multidisciplinary breast care.

CAP/ASH Initial Work-up of Acute Leukemia Guideline

Karl Theil, MD
Director, Cleveland Clinic Pathology Residency Program
Sept. 6, 8:00–9:15 am

There is variation in how acute leukemias are worked up across the country leading to variable practice and variable cost and time to diagnosis. The Initial Work-up of Acute Leukemia guideline developed by the Pathology and Laboratory Quality Center of the College of American Pathologists (CAP) and the American Society of Hematology (ASH) provides recommended testing for the initial work-up for proper diagnosis, determination of prognostic factors and for possible future monitoring of acute leukemias, including AML, ALL and mixed phenotype acute leukemia in children and adults.

GYN Cytology – Squamous cell Abnormalities: Recognition, Differential Interpretations, Management, Histopathologic Correlation and HPV Testing

Christine Booth, MD, Associate Program Director, Cleveland Clinic Pathology Residency Program
Fadi Abdul-Karim, MD, Staff, Cleveland Clinic Department of Anatomic Pathology
Sept. 8, 9:40–11:10 am

High-risk types of human papillomavirus can be identified in nearly all cervical squamous intraepithelial lesions. This presentation will discuss recent Pap test guidelines and the role of HPV testing in both screening and management. The stepwise progression from The Bethesda System (TBS), ALTS trial, and the ASCCP management guidelines to the ATHENA trial and the LAST project will be discussed, as they relate to squamous abnormalities of the uterine cervix. The first component of the conference will be in the form of presentations that address to following topics: the cytologic features of squamous cell abnormalities and their mimickers, the key findings of the ASC-US Low-grade Triage Study (ALTS), the ASCCP guidelines for the management of squamous abnormalities, the current ASC/ASCCP/ASCP Screening Guidelines for Pap screening and HPV testing and data from the Addressing the Need for Advanced HPV Diagnostics (ATHENA) study. There will be emphasis on the histopathology and natural history of CIN/dysplasia, cyto-histopathology correlation and the recommendations of The Lower Anogenital Squamous Terminology Standardization Project for HPV-associated Lesions (LAST). The second component of this conference will be a presentation of selected cases for audience polling/open discussion. These cases will serve to illustrate the principles described earlier and engage the attendees in a discussion of their experience and approach toward screening, interpretation and management.