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SC58 - Second Opinions and Discrepancies in Fine Needle Aspiration (FNA) Cytology: An Interactive Approach to Diagnostic Work-up



Evaluated by: Laura W. Lamps, M.D., UAMS Health, July 8, 2016
Original release date: March 8, 2016
Access to this course expires on: March 8, 2019
CME/SAMs 3.0

Course Description
Consultations in cytopathology are sought from experts in the handling of diagnostically challenging or indeterminate cases. Discrepancies in diagnosis may also be discovered when second opinions are obtained through inter-institutional transfer of patients care or in the setting of intradepartmental quality assurance (QA) and Peer-Review. Clinicians & patients themselves are increasingly seeking second opinion to confirm the initial diagnosis, especially if there are discordant clinical findings. Second opinion consultation in cytology is cost-effective, and is considered an important tool in ensuring quality management. Rendering accurate diagnosis in these settings ensures appropriate clinical management, and could prevent unnecessary invasive procedures and potential complications. This practical course is conducted by faculty from two major academic institutions, who have extensive experience in dealing with consultation cases. The course uses a case-based approach in a broad range of FNA cases. The cases include a spectrum of FNA sites that are more amenable to errors including lung, thyroid, lymph nodes, pancreas and salivary gland. The Course Directors share their approach to 8 cases selected from their consult, second opinion and QA files. Cases with discrepant diagnoses will be presented, with emphasis on differential diagnosis and detailed cytologic criteria. Review of pertinent clinical and radiologic information and comparison of corresponding histology are performed. Pertinent ancillary studies, such as immunocytochemistry, flow cytometry and molecular analyses are also discussed when applicable.

Target Audience
Practicing academic and community pathologists, and pathologists-in-training

Learning Objectives
Upon completion of this educational activity, learners will be able to: 

  • Learn about the common challenges and diagnostic discrepancies encountered in second-opinion/consult practice
  • Recognize the causes of such pitfalls, and how to best avoid them
  • Adopt a practical approach to workup and diagnosis of challenging cases.

The United States and Canadian Academy of Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The United States and Canadian Academy of Pathology designates this enduring material for a maximum of 3  AMA PRA Category 1 CreditsTM. 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). Registrants must take and pass the post-test in order to claim SAMs credit.

Physicians can earn a maximum of 3 SAM credit hours.

The faculty, committee members, and staff who are in position to control the content of this activity are required to disclose to USCAP and to learners any relevant financial relationship(s) of the individual or spouse/partner that have occurred within the last 12 months with any commercial interest(s) whose products or services are related to the CME content. USCAP has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.

The following faculty reported no relevant financial relationships: Tarik M. Elsheikh, MD, Cleveland Clinic, Cleveland, OH, Syed A. Hoda, MD and Rana S. Hoda, MD, New York Presbyterian Hospital, New York, NY

USCAP staff associated with the development of content for this activity reported no relevant financial relationships.

To earn CME and SAM credit, all learners must take a content-based exam and achieve a minimum score of 80%. If learners do not achieve a passing score of 80%, they have the option to retake the exam. After you pass the test and complete the evaluation, your certificate of completion will be available to view and print by clicking here.