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Diagnostic dilemmas in pancreatic pathology
S8
PATHOLOGY 2015 ABSTRACT SUPPLEMENT
of new genetic data across many tumor types was incorporated. Even since the completion of the latest volume (which was published almost a year after the consensus meeting at which the content was finalised), there have been important new findings in solitary fibrous tumour, a subset of rhabdomyosarcomas and among round cell sarcomas. Increasing genetic overlap among seemingly distinct tumour types is emerging and, in the future, the relative importance of phenotype versus genotype will need to be determined. There also remain opportunities to address significant nomenclatural problems.
BARRETT’S OESOPHAGUS AND BARRETT’S RELATED DYSPLASIA: CHALLENGES AND CONTROVERSIES Laura W. Lamps Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA Barrett’s oesophagus is a very commonly encountered entity in surgical pathology practice. However, the diagnosis of Barrett’s oesophagus, as well as the diagnosis, grading, and implications of dysplasia, present challenges to both pathologists and clinicians. This lecture will focus on the evolving definition of Barrett’s oesophagus; pitfalls in the diagnosis of Barrett’s oesophagus; and the diagnosis, grading, and implications of dysplasia in the context of Barrett’s oesophagus.
Pathology (2015), 47(S1)
understanding of the correlation between histological patterns of inflammation and specific organisms or groups of organisms has expanded, as has our understanding of how closely infections can mimic other frequently encountered diseases in gastrointestinal pathology (e.g., chronic idiopathic inflammatory bowel disease and ischaemia). Anatomical pathologists play a critical role in the diagnosis of gastrointestinal infections, as the examination of slides may provide a much more rapid result than microbiological cultures or other laboratory assays, and often cultures are not obtained before the patient is treated with antibiotics. This lecture will focus primarily on food and water-borne infectious enterocolitides, and how to distinguish them from other commonly encountered entities in gastrointestinal pathology.
DIAGNOSTIC DILEMMAS IN PANCREATIC PATHOLOGY Laura W. Lamps Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA The increase in high-resolution abdominal imaging has reportedly caused an increase in the recognition of pancreatic tumours, often at smaller sizes. In addition, these tumours are often sampled by needle biopsy and/or fine needle aspiration prior to definitive therapy, resulting in pathologists being asked to evaluate small samples of a much larger tumour. This lecture will highlight the clinical and pathological features of problematic pancreatic tumours, including cystic lesions and neuroendocrine tumours.
HOW SHOULD SURGICAL PATHOLOGY EVOLVE? Christopher D. M. Fletcher Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA This lecture will attempt to address the nebulous and perhaps philosophical issue of the manner in which surgical pathology should evolve in the next 10–20 years. Currently, surgical pathology reports provide more detailed and more clinically valuable (in fact currently irreplaceable!) information than ever before – at a time when fashion seeks to dictate that molecular genetic and genomic testing has the power to supersede conventional pathology almost entirely. ‘Personalised (or ‘precision’) medicine’, at whatever cost, is believed by many physicians (and patients) to be the way forward. Yet surgical pathologists continue to be of critical importance to optimal patient care through incorporation of novel tests that are properly validated (and cost-effective), integration of data from different testing modalities and also through guiding clinical decision-making and serving as a patient advocate.
UPDATE ON INFECTIOUS ENTEROCOLITIDES AND THE DISEASES THAT THEY MIMIC Laura W. Lamps Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA The anatomical pathologist’s ability to diagnose infections (including gastrointestinal infections) in tissue sections has improved greatly in recent years. With the increasing number and availability of new molecular assays and immunostains, pathologists’
DIAGNOSTIC PITFALLS IN SOFT TISSUE PATHOLOGY Christopher D. M. Fletcher Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA This lecture will focus on commonly encountered traps which may mislead pathologists when interpreting soft tissue lesions. These have been selected to reflect issues raised most frequently in consultation cases, based mainly on either over- or under-interpretation of morphological or immunohistochemical findings. Key themes include awareness of natural history (e.g., an inappropriate clinical context for a given diagnosis), benign lesions often mistaken for malignant (e.g., cellular benign fibrous histiocytoma, cellular schwannoma or lipomas with microscopic fat necrosis), malignant lesions easily mistaken as benign (e.g., low-grade fibromyxoid sarcoma and solitary fibrous tumour) and misinterpretation of immunohistochemical stains (e.g., use of needlessly broad panels, excessive antigen retrieval, mistaken assumptions regarding specificity and speculative but unvalidated use of biomarkers to distinguish benign from malignant).
NEW INSIGHTS IN SOFT TISSUE TUMOURS Christopher D. M. Fletcher Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA This lecture will focus on three broad areas which have brought new insights or broadened our understanding of soft tissue
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
PATHOLOGY 2015 ABSTRACT SUPPLEMENT
of new genetic data across many tumor types was incorporated. Even since the completion of the latest volume (which was published almost a year after the consensus meeting at which the content was finalised), there have been important new findings in solitary fibrous tumour, a subset of rhabdomyosarcomas and among round cell sarcomas. Increasing genetic overlap among seemingly distinct tumour types is emerging and, in the future, the relative importance of phenotype versus genotype will need to be determined. There also remain opportunities to address significant nomenclatural problems.
BARRETT’S OESOPHAGUS AND BARRETT’S RELATED DYSPLASIA: CHALLENGES AND CONTROVERSIES Laura W. Lamps Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA Barrett’s oesophagus is a very commonly encountered entity in surgical pathology practice. However, the diagnosis of Barrett’s oesophagus, as well as the diagnosis, grading, and implications of dysplasia, present challenges to both pathologists and clinicians. This lecture will focus on the evolving definition of Barrett’s oesophagus; pitfalls in the diagnosis of Barrett’s oesophagus; and the diagnosis, grading, and implications of dysplasia in the context of Barrett’s oesophagus.
Pathology (2015), 47(S1)
understanding of the correlation between histological patterns of inflammation and specific organisms or groups of organisms has expanded, as has our understanding of how closely infections can mimic other frequently encountered diseases in gastrointestinal pathology (e.g., chronic idiopathic inflammatory bowel disease and ischaemia). Anatomical pathologists play a critical role in the diagnosis of gastrointestinal infections, as the examination of slides may provide a much more rapid result than microbiological cultures or other laboratory assays, and often cultures are not obtained before the patient is treated with antibiotics. This lecture will focus primarily on food and water-borne infectious enterocolitides, and how to distinguish them from other commonly encountered entities in gastrointestinal pathology.
DIAGNOSTIC DILEMMAS IN PANCREATIC PATHOLOGY Laura W. Lamps Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA The increase in high-resolution abdominal imaging has reportedly caused an increase in the recognition of pancreatic tumours, often at smaller sizes. In addition, these tumours are often sampled by needle biopsy and/or fine needle aspiration prior to definitive therapy, resulting in pathologists being asked to evaluate small samples of a much larger tumour. This lecture will highlight the clinical and pathological features of problematic pancreatic tumours, including cystic lesions and neuroendocrine tumours.
HOW SHOULD SURGICAL PATHOLOGY EVOLVE? Christopher D. M. Fletcher Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA This lecture will attempt to address the nebulous and perhaps philosophical issue of the manner in which surgical pathology should evolve in the next 10–20 years. Currently, surgical pathology reports provide more detailed and more clinically valuable (in fact currently irreplaceable!) information than ever before – at a time when fashion seeks to dictate that molecular genetic and genomic testing has the power to supersede conventional pathology almost entirely. ‘Personalised (or ‘precision’) medicine’, at whatever cost, is believed by many physicians (and patients) to be the way forward. Yet surgical pathologists continue to be of critical importance to optimal patient care through incorporation of novel tests that are properly validated (and cost-effective), integration of data from different testing modalities and also through guiding clinical decision-making and serving as a patient advocate.
UPDATE ON INFECTIOUS ENTEROCOLITIDES AND THE DISEASES THAT THEY MIMIC Laura W. Lamps Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA The anatomical pathologist’s ability to diagnose infections (including gastrointestinal infections) in tissue sections has improved greatly in recent years. With the increasing number and availability of new molecular assays and immunostains, pathologists’
DIAGNOSTIC PITFALLS IN SOFT TISSUE PATHOLOGY Christopher D. M. Fletcher Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA This lecture will focus on commonly encountered traps which may mislead pathologists when interpreting soft tissue lesions. These have been selected to reflect issues raised most frequently in consultation cases, based mainly on either over- or under-interpretation of morphological or immunohistochemical findings. Key themes include awareness of natural history (e.g., an inappropriate clinical context for a given diagnosis), benign lesions often mistaken for malignant (e.g., cellular benign fibrous histiocytoma, cellular schwannoma or lipomas with microscopic fat necrosis), malignant lesions easily mistaken as benign (e.g., low-grade fibromyxoid sarcoma and solitary fibrous tumour) and misinterpretation of immunohistochemical stains (e.g., use of needlessly broad panels, excessive antigen retrieval, mistaken assumptions regarding specificity and speculative but unvalidated use of biomarkers to distinguish benign from malignant).
NEW INSIGHTS IN SOFT TISSUE TUMOURS Christopher D. M. Fletcher Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA This lecture will focus on three broad areas which have brought new insights or broadened our understanding of soft tissue
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.