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SC51 Part 1 - High Yield Urological Pathology: Common and Important Diagnoses Not To Be Missed in Daily Practice

Faculty: Ming Zhou, MD, PhD, New York University Medical Center, New York, NY, Kiril Trpkov, MD, University of Calgary, Calgary, AB and Rajal B. Shah, MD, Miraca Life Sciences, Irving, TX

Urologic pathology specimens constitute a significant portion of surgical pathologists daily work. There are numerous urologic diseases and neoplastic conditions that are histologically similar but have distinct clinical and therapeutic implications. Their correct diagnosis and classification are critical but often pose a significant challenge to surgical pathologists. Rather than reviewing general GU topics, the faculty of this short course have identified common diagnostic difficulties in GU pathology that surgical pathologists grapple with in daily sign-out based on their subspecialty sign-out and consultation experience.

Specifically, this course will review 11 cases and discuss:
  • Resolving atypical glandular lesions in prostate biopsies using an integrated morphological and immunohistochemical approach;
  • Common yet challenging benign mimics of prostate cancer and prostate cancer variants that mimic benign
  • Differential diagnosis and implications of atypical cribriform lesions in prostate biopsy
  • Contemporary Gleason grading scheme
  • Diagnostic algorithm for urothelial lesions with endophytic growth pattern
  • Benign mimickers of urothelial carcinoma
  • Morphological variants of urothelial cancer in TURBT biopsies
  • An approach to resolving difficult staging related issues in transurethral bladder resections
  • New and emerging renal cell carcinoma histological subtypes
  • Update on staging of renal cell carcinomas
  • Diagnosis of renal tumors on needle biopsy.
Discussion will focus on the morphological clues to diagnosis and differential diagnosis, judicious use of immunohistochemistry, clinical implications and take-home messages. A virtual slide and still images, along with histories, will be posted on the USCAP website for review by pre-registrants prior to the meeting. A syllabus reviewing diagnostic features and differential diagnosis, and providing a comprehensive reference list will be available online prior to the meeting. All course registrants will also receive web access to the PowerPoint presented at the USCAP Annual Meeting along with the text portion of the syllabus. The course is designed for advanced residents and general pathologists, as well as subspecialists in urological pathology.

Upon completion of this educational activity, participants should be able to:
  • Apply updated Gleason grading system
  • Use a pattern-based approach and algorithms in the diagnosis and differential diagnosis of urological neoplasms
  • Recognize new and emerging histological subtypes of renal epithelial neoplasms
  • Judicious use of immunohistochemical markers in the work-up of urological diseases

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