David B. Kaminsky, M.D., FIAC, March 21, 2018
Original release date:
May 29, 2018
Access to this course expires on:
March 21, 2021, at 11:59 PM Pacific Time
In this era of minimally-invasive procedures for diagnosis, prognosis and treatment decisions, pathologists are often the “first responders” analyzing and triaging limited specimens, including aspirates and small biopsies, and are continuously asked to make more specific diagnoses from those smaller samples. Clinicians increasingly request information regarding specific classification of the malignant tumors, and in many cases, application of additional prognostic and therapeutic markers to help guide their management. Although morphology remains the cornerstone of cytology and histology, ancillary studies can confirm and/or subclassify a malignancy in many cases; and although most pathologists recognize the crucial role of ancillary testing, it can be extremely frustrating for many of us to keep up with new advances and rapidly growing developments in the fields of immunohistochemistry and molecular techniques. There exists abundant literature describing new antibodies and molecular tests and panels, but it can be especially overwhelming to decipher which tests are actually most practical in the workup of a specific neoplasm or clinical presentation.
For these reasons, one of the purposes of this course is to present the efficient utilization of these ancillary studies based on differential diagnoses generated by the cytologic and/or histologic evaluation. In this long course, we gathered some of the top experts in their fields to discuss their strategies and most practical approaches to maximizing the information gained from limited specimens from a variety of organs, including lung, colon, soft tissue, brain, breast, metastases of unknown primary origin and hematologic specimens. Diagnostic challenges and potential pitfalls associated with limited specimens will be highlighted, and importantly, discuss which of the ancillary tests are more practical. This approach is of critical importance in helping the pathologist to serve as the gatekeeper for preserving tissue adequacy and becoming most efficient in triaging such specimens.
Practicing academic and community pathologists, and pathologists-in-training
Upon completion of this educational activity, learners will be able to:
- Provide strategies to maximize information gained from limited samples acquired from a variety of organs
- Explore diagnostic challenges and potential pitfalls associated with limited specimens
- Learn efficient utilization of ancillary studies based on differential diagnoses generated from the cytologic/histologic evaluation
- Characterize pathologists as the gatekeepers for preserving tissue adequacy and sustaining efficient triage of specimens
- Give pathologists tools and strategies to provide clinicians with information they need in this era of targeted therapies
Continuing Medical Education and Continuing Certification
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 5
AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
USCAP is approved by the American Board of Pathology (ABPath) to offer Self-Assessment credits (SAMs) and Lifelong Learning (Part II) credit for the purpose of meeting the ABPath requirements for Continuing Certification (CC). Registrants must take and pass the post-test in order to claim SAMs credit.
Physicians can earn a maximum of 5 SAM/Part II 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: Jan F. Silverman, M.D., Tarik M. Elsheikh, M.D., Jennifer A. Brainard, M.D., Carol F. Farver, M.D., Wendy Frankel, M.D., Christine Fuller, M.D., Jason L. Hornick, M.D., Ph.D., Erik Ranheim, M.D., Ph.D., Michael H. Roh, M.D., Ph.D., Stuart J. Schnitt, M.D.
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
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