Item Code: 3500-K

Item Name: Difficult Differential Diagnoses in GYN Cytology Secondary to Hormonal Influence

Michael R. Henry, MD

Presentation date: February 23, 2014; Expires: February 23, 2017

Cervical cytology varies tremendously depending on the hormonal status of the woman. This is especially true in the background of pregnancy (increased hormonal activity) or menopause (decreased hormonal activity). Increased or decreased levels of hormones create an environment, which affects the cervical mucosa and can lead to cellular changes that may be difficult to distinguish from true epithelial abnormalities.  This presentation addresses these issues with especial attention to atrophy versus HSIL and the epithelial changes seen in the background of pregnancy.

Item Code: 3500-I

Item Name: Glandular Lesions in Liquid Based Pap Tests:  Challenges of Hyperchromatic Crowded Groups 

Donna K. Russell, MS, CT(ASCP)

Presentation date: December 10, 2013; Expires: December 10, 2016

Despite limitations of the Pap Test for detecting glandular abnormalities, the cytology of glandular epithelium in the female genital tract has assumed greater importance in recent years.  Improved sampling of the endocervical canal and an increase in the incidence of endocervical neoplasms has had an impact in detection of these lesions and their mimickers.  This webinar will provide an overview of benign, reactive, and neoplastic glandular lesions in liquid based preparations (both Thin Prep® and SurePath® preparations).  Pitfalls in glandular lesion diagnosis and patient management issues are highlighted.

Item Code: 3500-D

Item Name: Pap Tests and Clinical Consequences: OB-GYN Observations on Pap Results

Harvey Cramer, MD and Jeffrey Rothenberg, MD

Presentation date: July 23, 2013; Expires: July 23, 2016

 In this presentation, an experienced gynecologist will discuss his perspectives on cervical cytology and outline clinical issues pertaining to cytology practice that most cytotechnologists and cytopathologists may not be aware of. Current cervical cytology screening guidelines, technical aspects of performing a pelvic examination and Pap smear procurement and the therapeutic ramifications of the various cytologic diagnoses as well as his personal perspectives on the use of HPV testing will be discussed. Comments regarding the cytomorphologic aspects of the cases being presented will be provided by the cytopathologist. The value of close interaction between clinician and cytopathologist is strongly emphasized.

Item Code: 3400-D

Item Name: Workload Limits and Quality Assurance in Image-assisted Gynecologic Screening
Tarik M. Elsheikh, MD                       

Presentation date:  July 24, 2012; Expires:  July 24, 2015

With the current and projected shortage of the cytotechnologist workforce and desires to reduce laboratory costs, markedly increased productivity with image assisted screening, not necessarily increased sensitivity, became an attractive option for many labs. This may be accomplished by imposing pre-determined productivity quota, and reducing QA measures to the minimum required by CLIA. More recent literature, however, has shown that the FDA approved cytotechnologist workload limits are too high and can lead to increased error rate, and that the CLIA-mandated quality measures, by themselves, may fail to detect poor cytotechnologist performers. In this webinar, review of recent literature and recommendations for cytotechnologist workload limits and QA measures are presented.

Archive Item Code: 3300-H

Item Name: Glandular Lesions in Pap Test: An Update
Rana S. Hoda, MD, FIAC                                             

Presentation date: November 22, 2011; Expires: November 22, 2014

A vast array of glandular processes present in Pap test cytology and distinguishing benign vs. neoplastic lesions can pose a diagnostic challenge.   This webinar has been designed to discuss morphologic criteria, differential diagnosis and benign mimics of glandular lesions in Pap test.  HPV testing, ASCCP patient management guidelines and histologic correlation will also be addressed. 

Archive Item Code: 3300-C

Item Name: Use of Imaging Systems in Gynecologic Cytology  
Angelique W. Levi, MD      

Presentation date: June 28, 2011; Expires: June 28, 2014

One-third of cervical cytology false-negatives are caused by screening and interpretive errors in which abnormal cells are incorrectly classified. Automated screening instruments address these key sources of error and cost.  FDA-approved imaging systems will be reviewed with a brief history of cytology automation, and the Yale experience will be discussed.

Archive Item Code: 3300-D

Item Name: Squamous Cell Abnormalities of the Uterine Cervix: Black and White with Shades of Gray 
Jamie L. Covell, BS, CT(ASCP)      

Presentation date: July 26, 2011; Expires: July 26, 2014

Since its inception in the 1940’s, the Pap test has focused primarily on the detection of squamous carcinoma and related lesions in the uterine cervix. This webinar discusses and illustrates the morphologic features of squamous abnormalities seen in Pap test specimens, their differential diagnoses and their mimics.

Archive Item Code: 3200-J

Item Name: Lessons From Cases of Screened Women Who Developed Cervical Carcinoma
R. Marshall Austin, M.D., Ph.D.

Presentation date: January 25, 2011; Expires: January 25, 2014

Although most cervical carcinoma cases in the US are diagnosed in never or seldom screened women, a significant subset of cases continue to be diagnosed in women who have had periodic cytologic screening. These cases represent a tiny subset of all screened cases and a small portion of all cases identified as “abnormal.” The most common cases in this “missed opportunity” category are glandular cervical cancers which occur in younger women, usually younger white women on oral contraceptives. Several such cases will be illustrated. Missed opportunities for the diagnosis of cervical squamous carcinoma most often turn on challenges surrounding identification of squamous cell abnormalities arising in immature squamous metaplastic cells or atrophy, sometimes in Pap tests with few abnormal cells. Multiple slide blinded reviews by staff are emphasized as a key educational technique to educate staff on the potential challenges for cytological recognition of slides in these categories. Emerging knowledge on the ability of HPV testing to enhance screening will also be discussed.

Archive Item Code: 3200-C

Item Name: Challenging Gynecologic Cases in Thin Prep and SurePath Preparations.             
Donna K. Russell, M.S. CT(ASCP)HT                                                 

Presentation date: June 22, 2010; Expires: June 22, 2013

Liquid based technology has led to improved sample adequacy and equal or superior results in the detection of pre-neoplastic cervical lesions. This teleconference will provide an overview of benign, reactive, and neoplastic lesions in liquid based preparations.  It will look at problem areas and focus on criteria that can be utilized to properly classify liquid based samples.  Pitfalls in the diagnosis of glandular lesions and high grade squamous intraepithelial lesions will be highlighted.  Ancillary techniques, as well as, patient management will be discussed. 

Archive Item Code: 3200-J

Item Name: Lessons From Cases of Screened Women Who Developed Cervical Carcinoma
R. Marshall Austin, M.D., Ph.D.

Presentation date: January 25, 2011; Expires: January 25, 2014

Although most cervical carcinoma cases in the US are diagnosed in never or seldom screened women, a significant subset of cases continue to be diagnosed in women who have had periodic cytologic screening. These cases represent a tiny subset of all screened cases and a small portion of all cases identified as “abnormal.” The most common cases in this “missed opportunity” category are glandular cervical cancers which occur in younger women, usually younger white women on oral contraceptives. Several such cases will be illustrated. Missed opportunities for the diagnosis of cervical squamous carcinoma most often turn on challenges surrounding identification of squamous cell abnormalities arising in immature squamous metaplastic cells or atrophy, sometimes in Pap tests with few abnormal cells. Multiple slide blinded reviews by staff are emphasized as a key educational technique to educate staff on the potential challenges for cytological recognition of slides in these categories. Emerging knowledge on the ability of HPV testing to enhance screening will also be discussed.

Archive Item Code: 3200-C

Item Name: Challenging Gynecologic Cases in Thin Prep and SurePath Preparations.             
Donna K. Russell, M.S. CT(ASCP)HT                                                 

Presentation date: June 22, 2010; Expires: June 22, 2013

Liquid based technology has led to improved sample adequacy and equal or superior results in the detection of pre-neoplastic cervical lesions. This teleconference will provide an overview of benign, reactive, and neoplastic lesions in liquid based preparations.  It will look at problem areas and focus on criteria that can be utilized to properly classify liquid based samples.  Pitfalls in the diagnosis of glandular lesions and high grade squamous intraepithelial lesions will be highlighted.  Ancillary techniques, as well as, patient management will be discussed. 

Archive Item Code: 3200-J

Item Name: Lessons From Cases of Screened Women Who Developed Cervical Carcinoma
R. Marshall Austin, M.D., Ph.D.

Presentation date: January 25, 2011; Expires: January 25, 2014

Although most cervical carcinoma cases in the US are diagnosed in never or seldom screened women, a significant subset of cases continue to be diagnosed in women who have had periodic cytologic screening. These cases represent a tiny subset of all screened cases and a small portion of all cases identified as “abnormal.” The most common cases in this “missed opportunity” category are glandular cervical cancers which occur in younger women, usually younger white women on oral contraceptives. Several such cases will be illustrated. Missed opportunities for the diagnosis of cervical squamous carcinoma most often turn on challenges surrounding identification of squamous cell abnormalities arising in immature squamous metaplastic cells or atrophy, sometimes in Pap tests with few abnormal cells. Multiple slide blinded reviews by staff are emphasized as a key educational technique to educate staff on the potential challenges for cytological recognition of slides in these categories. Emerging knowledge on the ability of HPV testing to enhance screening will also be discussed.