Description, Objectives, Bios, CanMEDS, COI
Thurs. Sept 9
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Thurs. Sept 9, 0815-0900 MT - Session 1 - Lymph Node Pathology Keynote - Updates in WHO Classification of B-cell Lymphoma: A Practical Perspective Application of emerging technologies have led to the recent updated edition of the 2017 WHO Classification that impact our diagnostic approach to B-cell lymphomas. Major updates include those related to precursor lesions in CLL/SLL, in situ follicular neoplasia, and in situ mantle cell neoplasia and the recognition of novel entities within BCL2 negative follicular lymphomas such as follicular lymphomas with 1p36 deletion, pediatric type follicular lymphomas and duodenal-type follicular lymphoma. There is enhanced understanding of the role of MYD88 mutations in the diagnosis and management of patients with lymphoplasmacytic lymphoma and subtypes of aggressive B-cell lymphomas. There is enhanced recognition of the broad spectrum of biologic behavior within mantle cell lymphomas such as indolent mantle cell lymphoma, cyclin D1 negative mantle cell lymphoma and blastoid variants of mantle cell lymphoma. Within the aggressive B-cell lymphomas, consensus guidelines for determination of cell-of-origin and other prognostic and theragnostic factors arepresented. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, laboratory technologists, pathology residents, and general and anatomic pathologists.
Thurs. Sept 9, 0900-0930 MT - Session 1 - Lymph Node Pathology Diagnosis and Workup of Aggressive B-cell Lymphomas At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Thurs. Sept 9, 0930-1000 MT - Session 1 - Lymph Node Pathology New Era of Core Lymph Node Biopsies: Review of the New Alberta Health Services Protocol Patients with cancer suspicion are faced with diagnostic delays, sub-optimal experience and outcomes, inappropriate investigations and uncoordinated care and supports. Cancer diagnosis pathways, and centralized and coordinated diagnostic services are lacking. Foundational work to expedite lung and breast cancer diagnosis was successfully implemented in Alberta, including radiologist-directed program notification, facilitated diagnostic investigations and referrals to specialists, standardized reporting, early support for patients and primary care, and wait-time and patient experience measurement. The Cancer SCN plans to spread these innovations to other cancers, and started with lymphoma in November 2020 where primary care is challenged with coordinating appropriate diagnostic investigations due to multiple access points with inconsistent referral processes. The provincial lymphoma diagnosis program will expedite diagnosis for patients with highly suspicious findings and implement assessment clinics at tertiary cancer centres to effectively triage patients with severe symptoms. Shifting of healthcare resource use from unnecessary surgical biopsies to Radiologist-facilitated core needle biopsies is part of the lymphoma diagnosis pathway. The pathway will also standardize eligibility criteria, centralized referral and triage processes, core needle biopsy procedures, pathology reporting, patient supports, scheduling staging investigations and consultations at the cancer centre, and quality measurement and reporting. Additional potential benefits include shorter time to diagnosis, decrease in hospitalizations prior to diagnosis, improved patient and family doctor satisfaction. To ensure sustainability and scale to most cancers, pathways will be anchored to centralized and coordinated cancer diagnosis services being designed with operations. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students Declaration of Conflict of Interest:
Thurs. Sept 9, 1030-1100 MT - Session 2 - Lymph Node Pathology Lymphoma Diagnosis in the Era of Needle Core Biopsies: Challenges and Pitfalls The World Health Organization system for lymphoma classification relies on histologic and immunophenotypic features from excisional biopsies. However due to a variety of factors, surgical and clinical practitioners rely heavily on fine-needle aspiration cytology and core needle biopsies to obtain primary diagnostic impressions for patients who have a clinical suspicion for lymphoma. Small lymph node biopsies in the form of core needle biopsies represent greater than 60% of all tissue biopsies obtained to establish a diagnosis of lymphoma. Given that over 60 distinct lymphoid malignancies are currently recognized by the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue, surgical pathologists and hematopathologists need to be aware of the best practices in the triage of small specimens to enhance diagnostic sensitivity and to understand the application of common ancillary tests for small lymph node biopsies. The session will be of value to laboratory technologists, pathology residents, and general and anatomic pathologists. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Thurs. Sept 9, 1100-1130 MT - Session 2 - Lymph Node Pathology Splenic B cell lymphoma diagnosis This session will provide an overview of splenic-based B-cell lymphomas. The distinguishing characteristics of different lymphoma subtypes will be discussed, along with the impact on therapy. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Declaration of Conflict of Interest:
Thurs. Sept 9, 1200-1400 MT - Session 2 - Lymph Node Pathology Practical Approach to the Diagnosis of T Cell Lymphoma This session will address the spectrum of T-cell lymphomas with emphasis on more commonly encountered lymphomas. Emphasis will be on differential diagnosis and pitfalls, as well as appropriate use of ancillary techniques including molecular and immunohistochemistry. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students Thurs. Sept 9, 1400-1430 MT - Session 3 - Lymph Node Pathology Updates in Pediatric Lymphoma Mature lymphomas that present in the pediatric population are rare and quite distinct from those that present in the adult population. Most B-cell lymphomas in the pediatric population are aggressive and composed of Burkitt lymphoma and diffuse large B-cell lymphoma. Recent studies using gene expression profiling and next generation sequencing have identified MYC negative Burkitt lymphomas that are characterized by 11q aberrations. Most diffuse large B-cell lymphomas in the pediatric population are of germinal center derivation and while comprehensive studies are lacking, they seem to be biologically distinct from adult diffuse large B-cell lymphomas. The most common form of mature T cell lymphoma in the pediatric population is the ALK+ anaplastic large cell lymphomas which are relatively easy to diagnose using comprehensive panel of immunohistochemical stains. Other T cell lymphomas are rare in this population. The 2017 WHO Classification provides updates on pediatric-type follicular lymphomas and large B-cell lymphomas with IRF4 rearrangement which should be distinguished from mimics of adult type follicular lymphoma and diffuse large Bcell lymphoma. The session will be of value to laboratory technologists, pathology residents, and general and anatomic pathologists. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Thurs. Sept 9, 1430-1500 MT - Session 3 - Lymph Node Pathology Infectious Diseases In Lympohreticular Pathology I will present an overview of the different ways in which infectious diseases can present in the surgical workload of a diagnostic pathologist. Due to the emphasis on malignant pathologies in everyday haematopathology practise, it can be easy to overlook the potential for an infection to present with clinical symptoms similar to other aetiologies which we commonly encounter such as malignancy, vasculitis, autoimmune disease etc. Also we see them less frequently and can be less certain of how to communicate to our clinician colleagues in Haematology and ID, in what can be urgent clinical situations. I will use exampels of common differentials suhc as granulomatous inflanmmation ina lymph ndoe biopsy to examine the role of morphology, specials stains, immunohistochemistry and molecular techniques to aid identification of specific infections, and demonstrate the importance of these in guiding treatment and avoiding diagnostic mistakes which can lead to inappropriate treatments. Examples cases including disseminated fungal infection, TB, coccidiomycosis, Leishmaniasis and will be discussed. I will also give a brief overview of the role of viral aretiology in haematopathology practice including the role of EBV in carcinogenesis, HHV-8 related lymphoproliferative diseases, and a consideration of the pathology of COVID infections. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students, Researchers, Cytotechnologists and Laboratory Medical Scientists Thurs. Sept 9, 1530-1615 MT - Session 4 - Lymph Node Pathology Division of Hematopathology Case Presentations (3 cases, 15 minutes/case) In this presentation, three interesting and challenging lymphoma cases will be presented. Two cases demonstrate challenges in diagnosis of lymphoma when immunohistochemistry alone is used to define the cell of origin and demonstrate the importance of ancillary molecular studies for lineage designation. The third case demonstrates the significance of clonal hematopoiesis in a subgroup of T-cell lymphoma and relationship with myeloid neoplasms. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Thurs. Sept 9, 1615-1700 MT - Session 4 - Lymph Node Pathology Keynote - Diagnostic Pitfalls In Lymphoma Diagnosis This session will focus on common B-cell lymphomas such as follicular lymphoma, mantle cell lymphoma, and address problems in differential diagnosis and the use of immunohistochemical and molecular techniques. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students |
Fri. Sept 9
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Fri. Sept. 10, 0815-0900 MT - Session 1Keynote – Molecular Pathology Molecular Testing Of Lymphoma This session will provide an overview of molecular testing in lymphomas, focusing on their utility in the diagnosis of lymphoma and in the subclassification of morphologically defined entities. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Fri. Sept. 10, 0900-0930 MT - Session 1 – Molecular Pathology Improving the Molecular Characterization of Myeloid Neoplasms Molecular genetic studies are essential for the accurate and reproducible work-up of myeloid malignancies. Current diagnosis of myeloid lesions relies heavily on a broad spectrum of karyotypic, single-gene and high-throughput molecular genetic methods. These methods will be reviewed, through the lens of clinical relevance and with a hope to provide attendees with strategies to select the correct ancillary study relative to the context. Attendees will be provided with strategies to avoid falling into costly and time-consuming "molecular genetic rabbit-holes." We will also discuss the implications of tumour-only testing to detection of potential germline events. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students, laboratory technical staff Declaration of Conflict of Interest:
Fri. Sept. 10, 0930-1000 MT - Session 1 – Molecular Pathology Immunogenetic Landscape Of Hematological Malignancies And Hematopoietic Stem Cell Transplantation Impact of Immune responses against hematological malignancies and pattern of immune reconstitution after Allogeneic Hematopoietic cell Transplantation (HCT) is frequently regulated by different immunogenetic systems like human Leukocyte Antigens (HLA), Killer Ig like Receptors (KIRs), and cytokine gene variants. In this presentation, we will learn about the impact of these immunogenetic determinants on the expression/production, and function of different immune mediators and blood cell subsets. We will also learn how these immunogenetic factors can be included in donor selection algorithms to improve outcomes of allogeneic HCT. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students Declaration of Conflict of Interest:
About the speaker Fri. Sept. 10, 1030-1100 MT - Session 2 – Molecular Pathology Role of Surgical Pathologist in Molecular Diagnostic Testing With advances in molecular diagnostics as a tool in surgical pathology, the general pathologist has an expanding role in its clinical utilization. The surgical pathologist's role is carried out in multi-disciplinary teams in patient management, test triage, preanalytical issues including tissue processing and preservation, molecular diagnosis and result integration and increasingly as a subject matter expert. This talk explores in detail how these various roles impact diagnosis, prognostication, prediction and therapy and how the surgical pathologist works with the molecular pathology laboratory for better patient care. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Fri. Sept. 10, 1100-1130 MT - Session 2 – Molecular Pathology Mismatch Repair and Microsatellite Instability: Practical Considerations in Molecular Testing of Colorectal Tumors This session will describe the process of screening for mismatch repair deficiency in colorectal tumors, explain the rationale behind universal screening for Lynch syndrome, highlight some key challenges in the implementation of universal screening, and describe potential solutions to overcome these challenges. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Declaration of Conflict of Interest:
Fri. Sept. 10, 1130-1200 MT - Session 2 – Molecular Pathology Testing for BRCA1/2 and Homologous Recombination Deficiency in Ovarian Cancer: Standard of Care At the end of the session, participants will be able to: Target Audience: Faculty, Residents, Medical Students Declaration of Conflict of Interest:
Fri. Sept. 10, 1200-1230 MT - Session 2 – Molecular Pathology Cancer Cytogenomics Understanding chromosomal abnormalities through conventional and molecular cytogenetic analyses is an integral component of current genomic medicine. This presentation will highlight the correlation between clinical, pathologic and cytogenetic information, and their impact on diagnosis and prognosis. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students Fri. Sept. 10, 1230-1300 MT - Session 3 – Molecular Pathology Integrating Pathology and Molecular Diagnostics for Pulmonary Neoplasms This presentation will introduce and review lung biomarker testing in standard anatomical pathology practice as it relates to pulmonary neoplasms. Review will be focused on current recommendations, tissue utilization and prioritization towards actionable biomarkers. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Declaration of Conflict of Interest:
Fri. Sept. 10, 1300-1330 MT - Session 3 – Molecular Pathology Molecular Testing of Cytology Specimens Molecular testing is now becoming a routine component of pathology and expectations are placed on the pathologist to review and refer appropriate specimens for testing. This presentation will focus primarily on the most common molecular tests ordered on cytology specimens. The discussion will include different cytology preparations and the preanalytical factors that determine success rates in molecular testing. The presentation will also define analytical and clinical sensitivity in molecular assays, discuss adequacy assessment in cytology specimens, and enumerate strategies for optimization of specimens for molecular studies. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents |
Sat. Sept 10
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Sat. Sept. 11, 0815-0900 MT - Session 1 - Molecular Pathology, Genetics & Genomics (Discussion Forum with Fellow panelists Jillian Parboosingh & Dennis Bulman) Molecular Pathology/Genomics Education Opportunities for Residents and Pathologists At the end of the session, participants will be able to: Target Audience: Dennis Bulman Declaration of Conflict of Interest:
About the speaker Sat. Sept. 11, 0900-0930 MT - Session 1 - Molecular Pathology, Genetics & Genomics Molecular autopsies in sudden death cases: a multi-discipline approach to implementing NGS testing for Inherited Cardiac Disorders This session will provide the participant with an overview of the use of genetic testing in the investigation of cause of death, including sudden unexplained death, of which NGS based cardiac gene panels are the newest to be implemented clinically. By their nature inherited cardiac conditions and how they may first present in a family requires a multidisciplinary approach that includes molecular genetics, clinical genetics, cardiology, pathology and the medical examiner's office. In Alberta these groups have come together to develop an algorithm for assisting the medical examiner in finding the genetic cause of an unexplained death and the counselling, testing and evaluating of at risk family members. At the end of the session, participants will be able to:
Target Audience: Faculty, Residents, Medical Students, Pathology Assistants Sat. Sept. 11, 0930-1000 MT - Session 1 - Molecular Pathology, Genetics & Genomics Direct to Consumer Genetic Testing: Issues and Challenges At the end of the session, participants will be able to: Target Audience: Sat. Sept. 11, 1015-1130 MT - Session 2 - Molecular Pathology, Genetics & Genomics Ethical Considerations in Testing and Reporting in Molecular Genetic Pathology Touching on the ethical considerations in testing and reporting in molecular pathology and showing the similarities and differences with respect to molecular genetic issues At the end of the session, participants will be able to:
Target Audience: Faculty, Residents Sat. Sept. 11, 1130-1200 MT - Session 2 - Molecular Pathology, Genetics & Genomics Interpreting Molecular Genetic Pathology Reports At the end of the session, participants will be able to: Target Audience: Declaration of Conflict of Interest:
About the speaker |