Course Program
Updated October 3, 2024
Thursday October 10, 2024
| Time | Title | Speaker | Objectives | Location |
| 0730-0900 | Registration | KC 100 Galleria South, Kinnear Centre, Banff Centre for Arts and Creativity | ||
| 0745-0845 | Full Breakfast | KC 103-105 | ||
| 0845-0850 | Opening remarks | Dr. Dylan Pillai & Dr. Ben Adam | KC 201-203 | |
| 0850-0900 | Introduction to the Day | Dr. Julinor Bacani & Dr. Steve Gorombey | KC 201-203 | |
| 0900-1000 | Thyroid nodule imaging: ultrasound, diagnostic correlations, and TIRADS classification | Dr. Adrian Sim | After this session participants will: 1. Be able to list three basic ultrasound principles pertinent to thyroid imaging. 2. Describe the approach of the American College of Radiology (ACR) TIRADS classification for thyroid imaging. 3. Recognize the appropriate management of thyroid nodules based on the ACR TIRADS score. | KC 201-203 |
| 1000-1100 | Thyroid cytology: The Bethesda System, molecular testing, and other essentials for the practicing pathologist | Dr. William C. Faquin | 1. Recognize that The 3rd Edition of the Bethesda System for Thyroid Cytopathology has eliminated the indeterminate category known as FLUS and that the Category III of the Bethesda System for Thyroid Cytopathology is limited to AUS. 2. Describe how Molecular testing can be very helpful for patient management in patients with indeterminate thyroid FNA results. 3. Explain how the predominant cytoarchitectural pattern is very useful for classifying thyroid FNA specimens using the Thyroid Bethesda System. | KC 201-203 |
| 1100-1115 | Coffee Break | KC 200 Galleria South | ||
| 1115-1215 | Essential elements of malignant thyroid pathology reporting (AKA how to please your endocrinologist!) | Dr. Sana Ghaznavi | 1. Recognize the pathologic features that determine DTC risk stratification and subsequent extent of surgery 2. Recognize the pathologic features that determine DTC risk stratification and subsequent radioactive iodine 3. Explain the role of pathology in integration of intraoperative and histological findings to determine the AJCC/TNM stage | KC 201-203 |
| 1215-1315 | Lunch Break | KC 103-105 | ||
| 1315-1415 | Case presentations (4 cases, 15 min each) | Dr. Tian Zhu Lu: Cribriform Morular Thyroid Carcinoma, Cytomorphology Dr. Daniel Finlaison: Special Considerations in the Management of Large Cell Neuroendocrine Carcinomas of the Lung Dr. Shubham Shan: They’re not like us!: What to do when it’s not papillary thyroid carcinoma (PTC)? Dr. David Twa: Primary hepatic neuroendocrine tumors: a diagnosis of exclusion | Dr. Tian Zhu Lu Objective: When encountering a suspected case of Cribriform Morular Thyroid Carcinoma, the learner should be able to order appropriate ancillary tests and correctly interpret the results. Dr. Daniel Finlaison Objective: To examine the rationale for biomarker testing in non-squamous non-small cell carcinomas of the lung Dr. Shubham Shan Objective: List two clinical examples of metastases in thyroid cytology specimens through patient case presentations Dr. David Twa Objective: Recognize the importance of Ki67 and mitotic count in grading neuroendocrine tumors (including the appropriate notation), that NETs are cytokeratin positive and that there is no pathognomonic staining pattern for a hepatic cell of origin. | KC 201-203 |
| 1415-1515 | Gastroenteropancreatic neuroendocrine neoplasms (NEN) – classifications and updates | Dr. Andrew Belizzi | 1. Apply the WHO 2019 GI “Blue Book” neuroendocrine classification to GEP NENs 2. Compare and contrast the GEP-NEN and WHO 2021 Lung NEN classifications 3. Recognize GEP NEN-relevant updates in the WHO 2022 Endocrine and Neuroendocrine Tumour “Blue Book”, including new terminology for small pancreatic neuroendocrine lesions (ie, neuroendocrine microtumour) and erstwhile gangliocytic paraganglioma (composite gangliocytoma/neuroma and neuroendocrine tumour; CoGNET) 4. Recognize clinically meaningful updates in the etiologic classification of gastric NETs, especially the emerging recognition of PPI-associated tumours 5. Distinguish NET site-specific frequent clinical/diagnostic conundrums | KC 201-203 |
| 1515-1530 | Coffee Break | KC 200 Galleria South | ||
| 1530-1630 | Utilization of immunohistochemistry in endocrine pathology – practical approaches | Dr. Andrew Belizzi | 1. Describe the role of general neuroendocrine marker immunohistochemistry in tumour diagnosis, including the specific strengths and limitations of synaptophysin, chromogranin A, and INSM1 2. Apply a panel of immunostains to determine neuroendocrine tumour (NET) site of origin 3. Apply a panel of immunostains to determine neuroendocrine carcinoma (NEC) site of origin 4. Apply a panel of immunostains to adjudicate the differential diagnosis of NET G3 vs NEC | KC 201-203 |
| 1630-1730 | ThyroSPEC: Update in Alberta | Dr. Adrian Box & Dr. Ralf Paschke | 1. Be able to list the indications for using Thyrospec testing to assist in the management of indeterminant thyroid nodules sampled by fine needle aspiration. 2. Be able to describe the concept of residual risk of malignancy (ROM) and how to interpret Thyrospec reports to address ROM. 3. Recognize the utilization of Thyrospec and clinical aspects of thyroid nodule malignancy risk assessment in Calgary and how it may differ from their own local practice. | KC 201-203 |
| 1730-1745 | Break |
Friday October 11, 2024
| Time | Title | Speaker | Objectives | Location |
| 0730-900 | Registration | KC 100 Galleria South, Kinnear Centre, Banff Centre for Arts and Creativity | ||
| 0745-0855 | Full Breakfast | KC 103-105 | ||
| 0855-0900 | Introduction to the Day | Dr. Julinor Bacani & Dr. Steve Gorombey | KC 201-203 | |
| 0900-1000 | Neuroendocrine neoplasms – diagnostic dilemmas and tools for grading; Mixed neruoendocrine non-neuroendocrine neoplasms (MiNEN) and high-grade tumours with neuroendocrine differentiation (NET vs. NEC. vs. Adenocarcinoma) | Dr. Andrew Belizzi | 1.Describe the biologic function of Ki-67, how it is expressed throughout the cell cycle, and how that could influence the quality of immunostaining 2. Recognize the potential sources of variation in the grade a patient’s neuroendocrine tumour (e.g., between laboratories), including the role of IHC technique, readout, and spatial and temporal heterogeneity 3. Apply an outcomes-centric approach to selection of blocks for Ki-67 staining in NET-resections 4. Compare and contrast the WHO GI 2010 and 2019 and the Endocrine/Neuroendocrine Blue Book definitions of neoplasms composed of mixed neuroendocrine and non-neuroendocrine components 5. Define differentiation, high-grade transformation, grade progression, divergent differentiation, and transdifferentiation and understand how they apply to high-grade and mixed tumours 6. Apply a morphology, epidemiology, and molecular genetic (including IHC surrogates) approach to the differential diagnosis of high-grade carcinomas of ambiguous lineage | KC 201-203 |
| 1000-1100 | Updates on NIFTP and other follicular-patterned thyroid neoplasms | Dr. William C. Faquin | 1. Be able to list the most common gene mutations associated with NIFTP 2. Recognize that the entire capsule of a thyroid lesion diagnosed as NIFTP should be examined microscopically to exclude invasion. 3. Recognize that the biologic behavior of NIFTP is similar to follicular adenoma. | KC 201-203 |
| 1100-1115 | Coffee Break | KC 200 Galleria South | ||
| 1115-1215 | Parathyroid pathology – updates, nomenclature, practical approaches and diagnostic dilemmas | Dr. Anthony Gill | 1. Recognize the new concept of atypical parathyroid adenoma/tumour 2. Be able to describe the pathological criteria for parathyroid carcinoma 3. Recognize the hereditary basis of parathyroid carcinoma 4. Recognize and describe ‘new entities’ including Lipoadenoma 5. Recognize the morphological features of tertiary hyperplasia in the setting of chronic renal failure and how these may mimic malignancy | KC 201-203 |
| 1215-1345 | Lunch Break | KC 103-105 | ||
| 1400-1500 | Lung neuroendocrine tumour nomenclature | Dr. Sebastiao Martins | 1. Be able to list/summarize key pathological and genomic features of neuroendocrine neoplasms of the lung. 2. Be able to explain the differences in nomenclature for small biopsies versus resection specimens, including implications for diagnosis and treatment. 3. Be able to compare and contrast the nomenclature of lung neuroendocrine tumours with that of neuroendocrine tumours in other organ systems, recognizing areas of overlap and the importance of consistency in a pathology report. 4. Describe the process of neuroendocrine transformation in non-small cell lung carcinoma (NSCLC) and its significance for diagnosis and treatment strategies. 5. Be able to discuss how precise nomenclature influences the clinical management of lung tumours, including implications for treatment and prognosis. 6. Through provided case studies, recognize the practical implications of accurate nomenclature in the diagnosis and treatment of lung neuroendocrine tumours. | KC 201-203 |
| 1500-1515 | Coffee Break | KC 200 Galleria South | ||
| 1515-1615 | Current Concepts in Thyroid Molecular Pathology and Diagnostics | Dr. Remegio Maglantay | 1. List the molecular alterations in common follicular and non-follicular derived thyroid neoplasms 2. Identify molecular markers for targeted therapy in thyroid cancer 3. Enumerate the different approaches to molecular diagnosis of thyroid nodules 4. Identify pre- and post-analytical factors that are essential in the proper interpretation of molecular test results | KC 201-203 |
| 1615-1715 | Overview of endocrine hereditary/genetic syndromes | Dr. Anthony Gill | 1. Recognize the mechanisms and tissue manifestations of DICER1 syndrome 2. Recognize the concept of SDH deficient neoplasia in paraganglioma, pituitary adenoma, GIST and renal carcinoma 3. List features of MEN1, MEN2, MEN4, and MEN5 syndromes 4. Recognize Glucagon Cell Hyperplasia and Neoplasia syndrome | KC 201-203 |
Saturday October 12, 2024
| Time | Title | Speaker | Objectives | Location |
| 0730-900 | Registration | KC 100 Galleria South, Kinnear Centre, Banff Centre for Arts and Creativity | ||
| 0745-0855 | Full Breakfast | KC 103-105 | ||
| 0855-0900 | Introduction to the day | Dr. Julinor Bacani & Dr. Steve Gorombey | ||
| 0900-1000 | Adrenocortical nodules: updates and practical tools to diagnostic work-up | Dr. Martin Hyrcza | 1. Recognize the importance of the examination of the background adrenal cortex in the diagnosis of cortical lesions. 2. Describe the spectrum of aldosterone-producing lesions and the new HISTALDO classification. 3. List the indications for the use of CYP11B2 immunohistochemistry. | |
| 1000-1100 | Pheochromocytoma and Paraganglioma – updates, diagnostic approaches, and reporting recommendations | Dr. Anthony Gill | 1. Recognize the strongly hereditary basis of phaeochromocytoma / paraganglioma 2. Describe the concepts of risk and malignancy in phaeochromocytoma / paraganglioma 3. List the differences between cauda equina NET and classical paraganglioma 4. List the differences between CoGNET and classical paraganglioma | |
| 1100-1115 | Coffee Break | KC 200 Galleria South | ||
| 1115-1215 | Medullary thyroid carcinoma and other uncommon thyroid neoplasms | Dr. William C. Faquin | 1. List the most common molecular alteration in medullary thyroid carcinomas and recognize that it is a mutation of the RET gene. 2. Recognize that C-cell hyperplasia is a histologic feature associated with inherited forms of medullary thyroid carcinoma. 3. Recognize that the gene fusion ETV6::NTRK is characteristic of secretory carcinomas and may allow targeted therapy | |
| 1215-1230 | Closing Remarks |
Dr. Andrew Bellizzi
- Gastroenteropancreatic neuroendocrine neoplasms (NEN) – classifications and updates
- Utilization of immunohistochemistry in endocrine pathology – practical approaches
- Neuroendocrine neoplasms – diagnostic dilemmas and tools for grading
- Mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) and high-grade tumours with neuroendocrine differentiation (NET vs. NEC vs. Adenocarcinoma)
- Participation and discussion of case presentations
Dr. Bill Faquin
- Updates on NIFTP and other follicular- patterned thyroid neoplasms
- Medullary thyroid carcinoma and other uncommon thyroid neoplasms
- Thyroid cytology: The Bethesda System, molecular testing, and other essentials for the practicing pathologist
- Participation and discussion of case presentations
Dr. Anthony Gill
- Pheochromocytoma and Paraganglioma – updates, diagnostic approaches, and reporting recommendations
- Overview of endocrine hereditary/genetic syndromes
- Parathyroid pathology – updates, nomenclature, practical approaches and diagnostic dilemmas
- Participation and discussion of case presentations
Invited local guest speakers:
- Dr. Remegio Maglantay
- Dr. Adrian Sim
- Dr. Sebastiao Martins
- Drs. Adrian Box and Ralf Paschke
- Dr. Sana Ghaznavi
- Dr. Martin Hyrcza
Case presentations Trainees/Faculty:
- Endocrine pathology case presentations (4 cases)