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Needs & Objectives

Georgia Association of Pathology
Virtual 2020 Annual Meeting

November 7, 2020

Educational Needs

Barrett’s esophagus and neoplasia in BE can be challenging to diagnosis. There are ancillary stains that could potentially help both in the diagnosis and prognosis of BE and associated dysplasia, but the literature and recommendations for clinical practice offer conflicting advice. This talk will address the need about how to best diagnose BE and BE-associated dysplasia and adenocarcinoma, including potential pitfalls.

Pathologists need to be aware of recent modifications in classification of colorectal polyps and those reportable features which are essential for risk stratifying patients with malignant polyps. The lecture includes a review of the WHO 2019 updates to the terminology used for serrated lesions with a brief review of their pathogenesis. In addition, we will address some common pitfalls in the assessment of invasive lesions and review the recommendations on high-risk features to report for adenocarcinoma encountered in polypectomy and biopsy specimens.

Pathologists desire to improve handling, grading, and diagnosis of Neuroendocrine Tumors. Specifically, they need an overview of key diagnostic and prognostic clues as well as recent advances in the field. While GIT and PB pathology courses are not uncommon, educational activities focused specifically on PB and GIT NENs are limited.

The Legislative and Advocacy Update is intended to educate attendees on recent events in Washington and Atlanta which concern Georgia pathologists.

RT-PCR-based assays for the detection of SARS-CoV-2 have played an essential role in the current COVID-19 pandemic. However, the sample collection and test reagents are in short supply, primarily due to supply chain issues. Thus, to eliminate testing constraints, multiple CLIA laboratories optimized key process variables: Sample collection and transport RNA extraction and RT-PCR reactions, different sample types, and media to facilitate SARS-CoV-2 testing. By performing various validation and bridging studies, labs have shown that various sample types such as a nasopharyngeal swab, bronchioalveolar lavage, and saliva, collected using conventional nasopharyngeal swabs, ESwab or 3D-printed swabs and, preserved in viral transport media, universal transport media, 0.9% sodium chloride or Amies media are compatible with RT-PCR assay for COVID-19.

Coagulopathy is a significant component of COVID-19 disease and patients with COVID-19 have increased rates of clotting and clotting-associated complications. The scale and acuity of the global pandemic has spurred a rapid evolution in our understanding of the pathophysiology of COVID-associated coagulopathy, necessitating educational and practice activities to best diagnose and manage these complex patients.

Pathologists need institutional experience with Covid-19 autopsies.

Educational Objectives

At the conclusion of the GAP 2020 Annual Meeting, attendees will be able to:

  1. Define Barrett’s Esophagus and how to handle biopsies taken at the GE junction.
  2. Discuss the significant interobserver variability in the diagnosis of dysplasia in BE and proposed refined criteria for the diagnosis.
  3. Identify the biomarkers that are needed to help confirm the histologic diagnosis of dysplasia and to stratify risk for patients with Barrett's esophagus.
  4. Discuss the diagnostic pitfall in staging early esophageal adenocarcinoma.
  5. Review the WHO 2019 updates to the terminology used for serrated lesions.
  6. Discuss common pitfalls in the assessment of invasive lesions and review the recommendations on high-risk features to report for adenocarcinoma encountered in polypectomy and biopsy specimens.
  7. Review types and classifications of Mucinous neoplasms of the appendix and the main differential diagnosis. 
  8. Describe the histologic and cytologic classification and grading of pancreatobiliary and gastrointestinal NENs with awareness of diagnostic pitfalls, morphologic mimics and challenges in small biopsies, FNAs and metastases.
  9. Distinguish classical well-differentiated and poorly differentiated neuroendocrine neoplasms from new entities such as grade-discordant and ambiguous NETs, accurately report them and provide information regarding their prognostic relevance.
  10. Utilize immunohistochemistry, including Ki-67, in the accurate diagnosis, classification and prognostication of NENs of the pancreatobiliary and gastrointestinal tract, recognizing the limitations of immunohistochemistry (CD56, hormonal markers) in diagnosis.
  11. Describe the clinical significance and immunohistochemical limitations in the distinction of hepatocellular carcinoma and intrahepatic cholangiocarcinoma.
  12. Identify the challenges of determining beta-catenin activation in hepatocellular adenomas.
  13. Discuss the utility of molecular assays in the diagnosis of hepatocellular tumors.
  14. Identify the legislative challenges faced by Georgia pathologists. 
  15. Explain how Georgia pathologists can influence legislative activities in Washington and Atlanta.
  16. Discuss the preparedness of laboratories and pathologists to battle the next pandemic with a focus on adopting a multi-pronged strategy in assay development, that are cost-effective, accurate, time-efficient, and that cater to mass testing.
  17. Discuss the importance of understanding the rules and laws in pandemic about lab medicine and testing. 
  18. Identify the risk and types of thrombotic complications in patients with COVID-19.
  19. Describe characteristics unique to COVID-19-associated hypercoagulability, such as blood hyperviscosity and fibrinolysis resistance, which may provide important therapeutic targets.
  20. Discuss the basic stages of ARDS and lung findings in COVID-19 patients.
  21. Discuss results from our largest series of COVID-19 autopsy cases with National and International institutions.
  22. Discuss a case of metastatic germ cell tumor to the subscapular lymph node in a male patient.