2015 Annual Meeting

SC58-Second Opinions and Discrepancies in Fine Needle Aspiration Cytology:  An Interactive Approach

2015 Annual Meeting

Room CC 208, March 26 2015, 1:00pm to 4:30pm

Tarik Elsheikh, Syed Hoda, Rana Hoda

Educational Objective

Consultations in cytopathology are sought from experts in the handling of diagnostically challenging or indeterminate cases. Discrepancies in diagnosis may also be discovered when second opinions are obtained through inter-institutional transfer of patient’s care or in the setting of intradepartmental quality assurance (QA) and Peer-Review. Clinicians & patients themselves are increasingly seeking second opinion to confirm the initial diagnosis, especially if there are discordant clinical findings. Second opinion consultation in cytology is cost-effective, and is considered an important tool in ensuring quality management. Rendering accurate diagnosis in these settings ensures appropriate clinical management, and could prevent unnecessary invasive procedures and potential complications. This practical course will be conducted by faculty from two major academic institutions, who have extensive experience in dealing with consultation cases. The course will use a case-based approach in a broad range of FNA cases. The cases will include a spectrum of FNA sites that are more amenable to errors including lung, thyroid, lymph nodes, pancreas and salivary gland. The Course Directors will share their approach to 8 cases selected from their consult, second opinion and QA files. Cases with discrepant diagnoses will be presented, with emphasis on differential diagnosis and detailed cytologic criteria. Review of pertinent clinical and radiologic information and comparison of corresponding histology will be performed. Pertinent ancillary studies, such as immunocytochemistry, flow cytometry and molecular analyses will be discussed when applicable. This course is designed for surgical pathologists with interest in cytology, cytopathologists, cytopathology fellows and pathologists-in-training. 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 prior to the course. 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. Upon completion of this course, participants should be able to:

  1. Learn about the common challenges and diagnostic discrepancies encountered in second-opinion/consult practice.
  2. Recognize the causes of such pitfalls, and how to best avoid them.
  3. Adopt a practical approach to workup and diagnosis of challenging cases.

Session Credits: CME = 3 / SAMs = N/A


SC Speaker
Speaker: Tarik M. ElSheikh, MD, Cleveland Clinic, Cleveland, OH
Access to Handouts
SC Speaker
Speaker: Syed Hoda, MD, New York Hospital Cornell Medical Center, New York, NY
Access to Handouts
SC Speaker
Speaker: Rana Hoda, MD, New York Presbyterian Hospital, New York, NY
Access to Handouts


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