DIAGNOSTIC PATHOLOGY UPDATE 2020

USCAP is a transformative leader in pathology education, creating better pathologists with updates in relevant information requisite for their performance and professional growth. The Academy is sensitive to the personal and cultural needs of practicing pathologists by providing conferences that welcome them with their families to exotic destination venues at which they are enriched with new knowledge and unusual experiences. The 2020 Diagnostic Pathology Update course combines expert subspecialized, academic faculty with exposure to ocean and rain forests symbolic of the dichotomy that is Costa Rica. From zip-lining to surfing, this tropical paradise brings pathologists into contact with the cuisine, agriculture, art and geography of a unique country that values education as its primary core value. Costa Rica has eliminated its standing army to use the savings from defense to improve education, health care and a durable social safety net.

USCAP is changing not only how we learn, but where we learn by re-imagining the learning environment and continuously elevating the quality of content. Experience top educators. Refine cognitive skills. Hold coffee beans in your hand. Inhale vapor from raging waterfalls. Witness rainbows in the evanescent colors of iguana skins. Feel sunsets scalding your memory.

Differentiating neoplastic from non-neoplastic disorders is one of the most difficult diagnostic challenges in pathology. Accurate diagnosis is paramount to initiate the appropriate treatment. It requires specific skills which often include at least some degree of clinical knowledge, awareness of the broad morphologic range and familiarity with ancillary tests. Errors in the interpretation of skin biopsies, especially in relation to melanocytic tumours, are among the most frequent causes for litigation in surgical biopsy and can lead to unfavorable patient outcomes. There are numerous pitfalls that diagnostic pathologists need to be aware of, including lack of relevant clinical information, sampling error and the wide morphologic spectrum of both inflammatory and neoplastic disorders, often showing overlapping findings and only subtle differentiating features. This special course will elevate your knowledge and polish your diagnostic skills as you interact with experts in a uniquely intimate mentoring environment.

Course Location: Palm Springs, CA
Course Director: Thomas Brenn, MD, PhD, FRCPath

Cytopathology possesses inherent diagnostic challenges in routine daily practice, compounded in recent years by numerous developments. Novel entities have been described, molecular alterations have been discovered, and multiple major shifts in diagnostic classification schemes have been introduced. It is difficult for pathologists to stay current and maintain proficiency in cytopathology without supplemental training and education.

There is growing demand and expectation by clinicians for pathologists to provide contemporary cytology services in this era of precision medicine, emphasizing cytopathology’s critical role as adjunct to targeted therapies. Accurate diagnosis is paramount to the initiation of appropriate treatment and depends on specific skills, clinical knowledge, awareness of the broad cytomorphologic range and overlap of lesions that may be encountered, and familiarity with ancillary tests.

This course is pragmatic, clinically oriented and stimulating. The selected cases are associated with potential diagnostic challenges and risks in day-to-day practice. Four experts provide an intimate mentoring experience in a superb learning environment that reflects USCAP’s educational standards.

Course Location: Palm Springs, CA
Course Director: Zahra Maleki, MD

Mediastinal pathology has a fascinating specificity in surgical pathology, because it is focused primarily on a single gland (the thymus) that involutes as we age, is more prominent in children than in adults, and requires a unique approach to diagnosis and clinical course. The infrequency of mediastinal tumors influences evolution of expertise by individual pathologists and their institutions. The recent introduction of new classification and staging schemas poses a novel challenge for those confronted with assessing mediastinal lesions. It is essential for practicing pathologists to become familiar with new modalities that impact treatment options and clinical outcomes. It is even more important to become familiar with the diversity of tumors that can occur in the mediastinal compartment. This course provides a unique opportunity for a tutorial in mediastinal pathology by a single internationally recognized expert from MD Anderson Cancer Center. It is limited to 17 attendees, so register now!

Course Location: Palm Springs, CA
Course Director: Cesar A. Moran, MD

Specimens represented by prostate needle core biopsies, transurethral resection of prostate (TURP), radical prostatectomy, kidney biopsies, nephrectomy (radical or partial), bladder biopsies, cystectomy (radical or partial), cystoprostatectomy, testicular biopsies or orchiectomy are frequently handled by pathology residents/fellows, general surgical pathologists and/or urologic pathologists in academic institutions and private practices. These specimens are associated with potential diagnostic challenges and risks in day-to-day practice. This experienced faculty has selected exemplary cases from their expert consultation files (and routine in-house cases) that illustrate recurrent professional practice gaps in urologic pathology. Through intimate mentoring, you will learn how to approach them, make accurate diagnoses, and avoid traps and pitfalls that could cause diagnostic error. The course is pragmatic, clinically-oriented and stimulating. It will focus on these issues:

• Benign tumor-like lesions of the prostate are often over-diagnosed as prostate cancer or atypical small acinar proliferations

• Secondary tumors involving the prostate are frequently misdiagnosed as prostate cancer

• Histological variants of prostate cancer with important clinical significance are under-recognized

• Therapy-related changes in benign glands and prostate cancer are frequently missed

• Extra-prostatic extension in prostate needle core biopsies is frequently missed • Recently described renal carcinomas are not well-appreciated

• Secondary tumors involving the kidney are occasionally misinterpreted as primary tumors

• Some variants of urothelial carcinoma are under-recognized

• Benign entities that mimic urothelial carcinoma are frequently misdiagnosed

• Testicular tumors still continue to pose diagnostic challenges

Course Location: Palm Springs, CA
Course Director: Adeboye O. Osunkoya

Course Location: Palm Springs, CA
Course Directors: Gregory Y. Lauwers, MD and Christina A. Arnold, MD

Course Location: Palm Springs, CA
Course Director: Robert P. Hasserjian, MD

Specimens from gynecologic organs constitute a significant component of most surgical pathology practices, which necessitates that practicing pathologists remain updated on advances in this dynamic, constantly evolving field. The diagnosis of gynecologic tract diseases can be challenging, and fraught with potential pitfalls that may have clinically significant consequences. Classical diagnostic issues in gynecologic pathology have revolved around the potential for non-neoplastic diseases, benign neoplasms, and malignancies to mimic each other, and for different histotypes of malignancies to display morphologic and/or immunophenotypic overlap. Within this context, pathologists must remain updated on newer approaches to disease classification, disease staging, and tumor grading. In this interactive microscopy course, the faculty will present cases wherein one lesion may potentially be mistaken for another due to varying degrees of morphologic and/or immunophenotypic overlap between them, or in which a cancer may be misclassified regarding grade, stage or primary site for a variety of reasons. The diverse case-mix will include those derived from both routine and consultation practices, reflecting the broad spectrum of gynecologic pathology. The presentation of cases will be clinically oriented, with an emphasis on day-to-day practical issues, and on accurately classifying each case within the context of a lesion-specific differential diagnosis

Course Location: Palm Springs, CA
Course Director: Oluwole Fadare, MD

Course Location: Palm Springs, CA
Course Director: Ming Zhou, MD, PhD

The Arthur Purdy Stout Society of Surgical Pathologists and USCAP continue their collaborative commitment to provide superb education for practicing pathologists. The Third Edition is designed to eliminate a variety of practice gaps in diagnostic surgical pathology. The faculty’s review of the literature and collective clinical experience as consultant surgical pathologists have revealed areas that remain problematic for pathologists. Examples include the categorization of proliferative breast lesions, biopsies of genitourinary tract, classification of inflammatory conditions of the upper gastrointestinal tract, distinction between usual interstitial pneumonia and its mimics, and the differential diagnoses of salivary gland tumors.

This interactive microscopy course attempts to eliminate diagnostic errors by highlighting pitfalls and approaches to resolve them using routine microscopic examination and immunohistochemistry. The roles of adjunctive molecular tests will be discussed as appropriate.

Thus, this course will address both medical knowledge and competence with the goal of improving clinical practice.

Registrants will have the opportunity to experience USCAP’s new international headquarters and learning center at the heart of vibrant Palm Springs, California, a unique and fascinating resort destination.

Course Location: Palm Springs, CA
Course Director: Marisa Nucci, MD

Course Location: Palm Springs, CA
Course Director: Deepa T. Patil, MBBS, MD

Specimens from gynecologic organs constitute a significant component of most surgical pathology practices, which necessitates that practicing pathologists remain updated on advances in this dynamic, constantly evolving field. The diagnosis of gynecologic tract diseases can be challenging, and fraught with potential pitfalls that may have clinically significant consequences. Classical diagnostic issues in gynecologic pathology have revolved around the potential for non-neoplastic diseases, benign neoplasms, and malignancies to mimic each other, and for different histotypes of malignancies to display morphologic and/or immunophenotypic overlap. Within this context, pathologists must remain updated on newer approaches to disease classification, disease staging, and tumor grading. In this interactive microscopy course, the faculty will present cases wherein one lesion may potentially be mistaken for another due to varying degrees of morphologic and/or immunophenotypic overlap between them, or in which a cancer may be misclassified regarding grade, stage or primary site for a variety of reasons. The diverse case-mix will include those derived from both routine and consultation practices, reflecting the broad spectrum of gynecologic pathology. The presentation of cases will be clinically oriented, with an emphasis on day-to-day practical issues, and on accurately classifying each case within the context of a lesion-specific differential diagnosis

Course Location: Palm Springs, CA
Course Director: Pei Hui, MD, PhD

Bone and soft tissue pathology is challenging, even for experienced surgical pathologists. Mesenchymal tumors are rare, show a wide morphologic spectrum with significant histologic overlap between benign and malignant tumors and between mesenchymal and non-mesenchymal tumors. Moreover, the classification of bone and soft tissue tumors continues to evolve with rare "new" entities being described with ever-increasing frequency on the basis of distinctive molecular or histologic features. As the field grows more complex, surgical pathologists may struggle to stay up to date with new entities, changes in staging guidelines, recently developed immunohistochemical and molecular diagnostic tests, and may therefore struggle with accurate diagnosis. To help resolve these issues and update your current knowledge, USCAP is offering a unique mentoring opportunity with experienced educators who can help you focus on these updates through interactive dialogue and shared exemplary cases.

Course Location: Palm Springs, CA
Course Director: Elizabeth G. Demicco, MD, PhD

Head and neck pathology represents a significant portion of surgical pathology practice. Studies have shown this area to be particularly treacherous to community pathologists with up to 53% of diagnoses changed (including 7% with major changes) upon second review at tertiary care hospitals (Kronz and Westra, Curr Opin Otolaryngol Head Neck Surgery 2005; 13:81-4).

In recent years there have been numerous developments in head and neck pathology, further complicating this inherent difficulty. Novel entities have been described, pathognomonic molecular alterations have been uncovered, and major shifts in diagnostic classification schemes have been proposed. Many of these concepts were incorporated into the newest editions of the WHO Classifications for Head and Neck and Endocrine Tumors, both of which were published recently.

Taken together, it is difficult for pathologists to stay current and maintain proficiency in head and neck pathology without supplemental training and education. This course is a terrific opportunity to refine your diagnostic skills in a uniquely personal mentoring environment with energetic pathologists whose keen eyes, diagnostic acumen, and a modern approach will create an indelible impression.

This course is designed for general pathologists, practicing surgical pathologists, senior residents and pathologists with special interest in head and neck pathology.

Course Location: Palm Springs, CA
Course Director: Justin Bishop, MD

Mesenchymal tumors are inherently diagnostically challenging, but a significant practice gap in their interpretation has developed as new entities and genetic abnormalities have emerged. Diagnostic challenges are associated with distinguishing benign spindle cell proliferations from high grade sarcoma due to histologic and immunohistochemical overlap. In addition to benign and malignant categories, contemporary classification of mesenchymal neoplasms emphasizes lesions with intermediate biologic potential, including those that are locally aggressive or rarely metastasize. There are circumstances in which pathologists can render only descriptive diagnoses without precise classification. New discoveries in molecular genetics have clarified some of these problematic lesions. Furthermore, there are newly described entities that practicing pathologists should be aware of so that tumors are appropriately diagnosed and optimally treated. This course, presented by expert mentors and educators, explores a comprehensive panorama of lesions and anatomic sites.

Course Location: Palm Springs, CA
Course Director: Andre Pinto, MD

Course Location: Palm Springs, CA
Course Director: Edi Brogi, MD, PhD

Course Location: Palm Springs, CA
Course Director: Rish K. Pai, MD, PhD

The gastrointestinal tract remains one of the most common sources for surgical pathology specimens. As a result, the difficulties and gray areas in this subspecialty are encountered quite often by pathologists each day. The existence of interobserver variability in many gastrointestinal diagnoses compounds this issue. In contrast, the liver and pancreas give rise to a broad spectrum of uncommon disease entities, making it difficult for pathologists who don’t specialize in these organs to gain diagnostic proficiency. Finally, the WHO recently released the newest edition of their Digestive Tract Tumours blue book which contains key updates and subtle changes that may be unfamiliar to many practicing pathologists.

This course will tackle the professional practice gaps that exist in gastrointestinal pathology, focusing on uncommon findings, obfuscated differential diagnoses, new entities and changes to existing entities.

It is a perfect complement to the preceding course, Liver Pathology’s P’s and Q’s: The Perplexing and the Quotidian (January 25-27, 2021).

Course Location: Palm Springs, CA
Course Director: Rish K. Pai, MD, PhD

Course Location: Palm Springs, CA
Course Directors: Henry D. Tazelaar, MD & Andrew Churg, MD

Distinguishing between reactive and neoplastic proliferations in blood, bone marrow, lymph nodes, spleen and extra-nodal hematopoietic tissues, as well as accurately classifying neoplasms once they are identified, are essential for appropriate patient care. Pathologists struggle with differentiating reactive from neoplastic conditions in these organs, as well as in properly classifying hematopoietic neoplasms once they are diagnosed. This highly respected expert faculty will provide a unique mentoring experience in an intimate study environment at USCAP’s Interactive Learning Center. They intend to cover diagnostic criteria for new entities in the 2016 WHO Classification of Hematopoietic and Lymphoid Neoplasms and provide useful morphologic clues and ancillary techniques to help you distinguish neoplastic and reactive conditions..

Course Location: Palm Springs, CA
Course Director: Daniel A. Arber, MD

Course Location: Palm Springs, CA
Course Director: Stuart J. Schnitt, MD

Accurate diagnosis in hematopathology relies heavily on the complex integration of data from clinical presentation, conventional microscopy, immunohistochemistry, flow cytometry, and molecular and cytogenetic analyses. Diagnosis is often complicated by the fact that clinically relevant disease subsets can share overlapping diagnostic features, and both baseline appreciation for disease spectrum and appropriate application/interpretation of ancillary testing is lacking. This gap can lead to real and immediate clinical consequences for therapeutic selection and overall patient management.

While in-house testing for the vast array of available diagnostic, prognostic and predictive markers is not possible in every setting or practice, awareness of their applicability and impact on patient care is the responsibility of both the pathologist and treating clinician. This is particularly true in an era when patients are increasingly knowledgeable about genomic and proteomic analyses and the studies are easily accessible. Approaching this target by strengthening baseline knowledge and skill in application empowers the pathologist as a consultant to the clinical care team. This superb faculty will synthesize and deliver this strategic philosophy in the context of intimate mentoring and personalized attention to detail.

Course Location: Palm Springs, CA
Course Directors: Olga K. Weinberg, MD and Yuri Fedoriw, MD