Thank you for attending our companion meeting at USCAP 2025 and celebrating our 10th anniversary! A summary of the program is below; PDF versions of the presentations can also be downloaded from the links below.
The future of everyday diagnostics in pancreatobiliary pathology
Diagnostics in pathology have been evolving rapidly in recent years, with the advent of technology bringing profound changes to the way pathologists sign out pancreaticobiliary specimens. A major revolution in recent years has been brought about by molecular diagnostics, which has not only allowed us to better understand the biology of pancreatobiliary neoplasms but has led to the development and implementation of new biomarkers with different diagnostic, prognostic, and/or predictive value. Additionally, the use of digital pathology in our daily practice is increasingly available for different tasks. For all these reasons, the PBPS has structured a course that starts from the basics of pathology, that is, gross examination, up to the most modern techniques in the field, all intended with an eye toward the future. The PBPS aims to show how classical pathology meets innovation, and how we can be prepared to handle all these evolving changes in our daily practice. In this session, 4 expert speakers, each of whom has published extensively on these topics, will describe state of the art and future scenarios in the fields of macroscopic sampling, immunohistochemistry – also in those cases in which it can be integrated with digital pathology, molecular studies including cyst fluid analysis, and pancreatobiliary precancers. Each speaker will cover each of these topics in a 25-minute presentation, followed by an additional 5-minute Q/A session (total: 2 h)
The course will start firstly with a lecture on macroscopic sampling of the pancreas, with a specific focus on Whipple resections. Here, the advantages and disadvantages of two grossing methodologies, namely the axial and bivalving techniques, will be explored. In addition, a newly-developed third method, the sagittal method, which is based on the embryology of the pancreas, will also be introduced. Following this session, a review of ancillary immunohistochemical studies in pancreatobiliary diagnostics will be provided, with a focus on the most important or recently identified diagnostic markers, along with new insights on prognostic and predictive markers. Additionally, digital pathology tools, including new platforms based on artificial intelligence algorithms and digital assessment of Ki-67 in neuroendocrine neoplasms will be discussed. The third topic will address the use of molecular studies in pancreatobiliary pathology, with a specific focus on the molecular analysis of cystic fluid, which is of central importance in the early diagnosis of cystic pancreatic neoplasms. Lastly, the current state and future of pancreatobiliary precursor lesions will be presented with an emphasis on 3-dimensional reconstruction of pancreatic precursors, combined with the integration of molecular alterations, to gain a comprehensive understanding of morphology and its underlying genetic drivers.
Course Learning Objectives
Upon completion of this educational activity, learners will be able to:
- Recognize the advantages and disadvantages of the different approaches for the macroscopic examination of pancreatoduodenectomy specimens. B). Apply the best approach, based on various clinical settings, after gaining a comprehensive understanding of the different grossing approaches.
- Acquire knowledge about the recent developments of immunohistochemistry in the field and in which settings they are best applied. B) Appraise the new applications of artificial intelligence-based systems for digital pathology in the pancreatobiliary specimens.
- Integrate essential insights gained about molecular pathology in the field of pancreatobiliary diseases, with specific focus on cyst fluid analysis and pancreatobiliary precursor lesions. B) Select appropriate and optimal diagnostic, prognostic, and predictive molecular biomarkers after learning about recently emerging and new developments in this field.
Course Outline
- Macroscopic examination of pancreatic specimens: pros and cons of the different methodologies.
Dr. Olca Basturk, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Dr. Basturk’s presentation - Immunohistochemistry and digital pathology for pancreatobiliary diseases.
Dr. Xuchen Zhang, Yale University School of Medicine, New Haven, CT, USA
Dr. Zhang’s presentation - Molecular studies and cyst fluid analysis of pancreatobiliary pathology.
Dr. Michëal Noë, Amsterdam University Medical Center, Amsterdam, the Netherlands
Dr. Noe’s presentation - Pancreatobiliary precursor lesions now and in the future.
Dr. Laura Wood, Johns Hopkins University, Baltimore, MD, USA
Dr. Wood’s presentation
Session moderators:
Dr. Huaibin M. Ko (Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA) and
Dr. Massimo Milione (National Cancer Institute, Milan, Italy).