VSRSAPLV2501 - CME/CMLE - Financial Management Essentials for Biomarker Testing-VSRSAPLV2501

Video Transcription

Video Summary

The ASCP virtual slide review series, presented by Dr. Galisa Turashvili and moderated by Dr. Yasmine Butt, explored challenging differential diagnoses in small gynecologic specimens through seven case studies. The session emphasized a stepwise diagnostic framework, focusing on key morphologic features impacting clinical management, and leveraging whole slide imaging for accurate interpretations.<br /><br />Cases highlighted included: <br />1) HPV-associated endocervical adenocarcinoma misinterpreted in endometrial curettage, identified via prominent apical mitoses and P16 and HPV RNA testing.<br />2) Gastric-type HPV-independent endocervical adenocarcinoma, often with bland cytology but aggressive behavior, distinguishable by mucin stains.<br />3) Mismatch repair (MMR) deficient endometrioid carcinoma with architectural and cytologic discrepancies resolved using p53, p10, and MMR IHC.<br />4) Low-grade endometrioid carcinoma with unusual spindle cell areas classified as corded and hyalinized endometrioid carcinoma (CHEC), differentiated from carcinosarcoma by p53 and morphology.<br />5) High-grade glandular serous carcinoma diagnosed by marked atypia and mutated p53 despite glandular architecture.<br />6) Dedifferentiated carcinoma featuring both gland-forming and undifferentiated components, often MMR deficient with BRG1 loss.<br />7) High-grade sarcoma with rhabdomyoblastic differentiation, with differential diagnosis including carcinosarcoma, emphasizing caution in small biopsies.<br /><br />The series underscored the critical role of morphology, immunohistochemistry, and ancillary testing in accurate diagnosis, as well as challenges posed by limited samples. Molecular classification, while informative, was considered not yet routine for guiding therapy in carcinosarcomas.

Keywords

ASCP virtual slide review

gynecologic specimens

differential diagnosis

endocervical adenocarcinoma

HPV-associated cancer

mismatch repair deficient carcinoma

immunohistochemistry

morphologic features

carcinosarcoma