Case 3: Quarter 4, 2023
Clinical Details:
A 70-year-old woman who had no significant past medical history presented with 4 months of intermittent jaundice, nausea, itching, and fever. Radiological investigations and ERCP were performed and revealed the interruption of the choledochal lumen due to the presence of a solid-looking neoplasm. The ERCP biopsy was very small and fragmented but was positive for the presence of cells with high-grade dysplasia. The patient underwent pancreaticoduodenectomy.
See figures and answer here: Case 3: Quarter 4, 2023
November is Pancreatic Cancer Awareness Month
November is Pancreatic Cancer Awareness Month, a time dedicated to raising awareness about this deadly disease and advocating for early detection, research, and improved treatment options. During this awareness month, organizations like the Pancreatobiliary Pathology Society, healthcare professionals, and communities come together to educate the public about the risk factors, symptoms, and importance of early diagnosis. By spreading awareness, we can encourage individuals to pay attention to their bodies, recognize potential warning signs, and seek medical advice promptly. Additionally, Pancreatic Cancer Awareness Month serves as a reminder of the urgent need for research funding to develop better diagnostic tools and innovative treatments, ultimately improving the chances of survival for those diagnosed with this devastating disease.
Supporting Pancreatic Cancer Awareness Month also means extending a hand to patients and their families, offering them the emotional and practical support they need. It’s an opportunity for communities to come together to honor the memories of those who have fought or are currently fighting pancreatic cancer. By fostering a sense of unity and understanding, we can work towards a future where pancreatic cancer is diagnosed at an earlier stage, treatments are more effective, and, ultimately, find a cure for this challenging illness.
Also, Thursday, November 16 is World Pancreatic Cancer Day – an even more focused opportunity to recognize this disease and the numerous efforts to improve the care of those affected. Please remember to “wear purple” and spread the word.
Olca Basturk, President
Pancreatobiliary Pathology Society
The PBPS is seeking new Case of the Quarter Committee Members
The Case of the Quarter (CoQ) Committee for the Pancreatobiliary Pathology Society is seeking six new committee members to join our team for a term of 2 years starting from March 1, 2024.
The CoQ will publish six times each year (January 15th, March 15th, May 15th, July 15th, September 15th and November 15th) on the PBPS website. Every CoQ committee member is responsible for submitting or soliciting at least one case during each year of their term on the CoQ committee. The CoQ members are responsible for the selection, writing, editing, and final submission of an interesting CoQ for publication on PBPS website (https://pbpath.org/). The CoQ is a valued educational tool among our community and a great way to network with others in the field.
Interested PBPath members should send their CV to info@pbpath.org by Friday September 15, 2023. Applicants must be members of the Pancreatobiliary Pathology Society.
Case 2: Quarter 2, 2023
Clinical Details:
A 56-year -old female with chronic left upper quadrant abdominal pain of more than 10 years duration with multiple comorbidities including endometriosis, ovarian cyst, right renal stones, diverticulosis, and pancreatic cyst. The pancreatic cyst was incidentally discovered on abdominal MRI, located in the pancreatic head, measuring 2 cm in greatest dimension. EUS and CT scan showed a multilobulated cystic lesion (2.5 cm) with a solid component, not in communication with the main pancreatic duct. EUS guided fine needle aspiration (FNA) and biopsies were performed for 3 times to establish the diagnosis. All three FNA and biopsies were reported as negative for malignancy or atypical cells. Cyst fluid showed a low CEA (<2 ng/ml) and cyst fluid was negative for KRAS mutation. The patient continued to have chronic left upper quadrant pain and it was recommended that she undergo Whipple surgery for definitive management of her pancreatic cyst.
See figures and answer here: Case 2: Quarter 2, 2023
USCAP 2023 Highlights
Pancreatobiliary Pathology Society Best Abstract Award of USCAP2023 goes to Dr. Dalia Elganainy.
Congratulations to Dr. Dalia Elganainy, of Dana-Farber Cancer Institute, Harvard Medical School, who was awarded the Pancreatobiliary Pathology Society’s Best Abstract at USCAP 2023! Dr. Elganainy’s winning abstract is entitled “Landscape, Spatial Organization and Clinical Correlates of Stromal Content and Fibroblast Subtypes in Primary Pancreatic Adenocarcinoma Assessed by Multiplexed Immunofluorescence and Digital Imaging.” Dr. Elganainy was presented the award at USCAP 2023 by Drs. Wang and Basturk.
The authors for this abstract are listed below:
Dalia Elganainy, MD, Dana-Farber Cancer Institute, Harvard Medical School (Primary Presenter)
Andressa Dias Costa, MD, Dana-Farber Cancer Institute
Sara A. Väyrynen, MD, PhD, Dana-Farber Cancer Institute
Hannah Williams, PhD, Dana-Farber Cancer Institute
Chen Yuan, Dana-Farber Cancer Institute
Kimberly Perez, MD, Dana-Farber Cancer Institute, Harvard Medical School
Harshabad Singh, MD, Dana-Farber Cancer Institute, Harvard Medical School
Richard F. Dunne, MD, University of Rochester Medical Center
Thomas E. Clancy, MD, Brigham and Women’s Hospital
Daniel T. Chang, MD, Stanford Cancer Institute
Brian M. Wolpin, MD, Dana-Farber Cancer Institute, Harvard Cancer Center
Jonathan Nowak, MD, PhD, Brigham and Women’s Hospital
Message from the President, PBPS at USCAP 2023
Dear Pancreatobiliary Pathology Society Members,
We are gearing up for another annual USCAP meeting! Our Companion Society session will be held on Sunday, March 12th from 10:30 AM to 12:30 PM in Great Hall A of the New Orleans Convention Center. The PBPS Annual Business Meeting will immediately follow.
This year’s companion meeting will have two components:
Part I will be dedicated to presentations on Interpretation of Small Biopsies and Frozen Sections of the Pancreatobiliary Tract. The chosen topics represent expert evaluations of the full spectrum of small biopsies one may see in practice, from the cytopathologist’s perspective (Dr. Martha Pitman – WHO International Classification System for the Reporting of Pancreatobiliary Cytology Specimens) to their histomorphologic characteristics (Dr. Alyssa Krasinskas – Bile Duct and Ampulla; Dr. Claudio Luchini – Pancreas), and frozen section evaluation (Dr. Wendy Frankel).
Part II will be dedicated to an interactive discussion moderated by Drs. Vikram Deshpande and Grace Kim. For this part, we will utilize the PBPath Society Twitter account to post questions in advance (Please keep an eye on our Twitter account https://twitter.com/pbpath for more information on that).
Thanks to the members of the Executive and Education Committees who are dedicated to the growth of our Society and have worked hard to increase our outreach and be impactful, there is more good news:
The PBPath Society, in collaboration with the Chinese American Pathologist Association (CAPA), will participate in the 13th annual Asia Pacific International Academy of Pathology meeting in Malaysia in June, 2023. Ampullary carcinoma (Dr. Volkan Adsay) cholangiocarcinoma (Dr. Seung Mo Hong) and intraductal papillary neoplasms of the bile duct (Dr. Yoh Zen) will be discussed.
Additionally, Drs. Alyssa Krasinskas and Barbara Centeno will present our society’s official short course titled “The ABCs to XYZs of Pancreatic Surgical and Cytopathology” at the next annual CAP meeting in October, 2023.
Lastly, if you have not already done so, we would also like to take this opportunity to remind you to renew your membership. We look forward to seeing you all in New Orleans, LA!
Sincerely,
Olca Basturk, President
Pancreatobiliary Pathology Society
Case 1: Quarter 1, 2023
Clinical Details:
A 41 y/o male initially presented with nausea, vomiting, epigastric pain and severe diarrhea. Imaging (CT scan and MRI) revealed a 3.9 cm hypervascular mass centered on the pancreatic uncinate process with no evidence of metastatic disease. The imaging findings were concerning for lymphoma or a neuroendocrine tumor. Laboratory studies including amylase, lipase, and CA 19-9 were within normal limits. Endoscopy with fine needle biopsy of the lesion was performed.
See figures and answer here: Case 1: Quarter 1, 2023
Pancreatobiliary Pathology Society Abstract Award at USCAP 2023
Dear members of the PBPS,
The PBPS is now accepting applications for this year’s PBPS Abstract Award. This award will go to a pathology trainee with an abstract (poster/platform) in pancreatobiliary pathology to be presented at the 2023 USCAP Annual Meeting. Submitted abstracts will be evaluated by the members of Education Committee for originality, scientific merit, and presentation. The selected winner will be notified by email from the Chair of Education Committee and the winner will receive a $500 prize. The qualifications for this award are listed below:
- Only abstracts that were accepted for presentation at this year’s annual USCAP meeting are qualified for the PBPS Best Abstract Award.
- Only trainees (medical students, residents, or fellows) are qualified for this award.
The submitting trainee must be a member of the PBPS. Please note that associate membership in the PBPS is free for trainees. Trainees are strongly encouraged to apply. - The submitting trainee must be first author (except in rare instances in which the trainee may be listed as the senior author).
- Trainees will not receive an award if they have won in the prior year. If you are the winner of the PBPS award for last year, then you do not qualify for consideration for the current year.
- The deadline for submission of Award applications is 12:00 pm (US Central time) on February 6, 2023.
Please submit your abstract online (https://pbpath.org/abstract-submission/).
We look forward to receiving your submission.
Education Committee
The Pancreatobiliary Pathology Society
Case 3: Quarter 4, 2022
Clinical Details:
A 41 y/o male initially presented with nausea, vomiting, epigastric pain and severe diarrhea. Imaging (CT scan and MRI) revealed a 3.9 cm hypervascular mass centered on the pancreatic uncinate process with no evidence of metastatic disease. The imaging findings were concerning for lymphoma or a neuroendocrine tumor. Laboratory studies including amylase, lipase, and CA 19-9 were within normal limits. Endoscopy with fine needle biopsy of the lesion was performed.
See figures and answer here: Case 3: Quarter 4, 2022
Pancreatic Cancer Awareness Month
Dear All,
November is the Pancreatic Cancer Awareness Month. Recognition of the growing prevalence of pancreatic cancer, with the help of foundations and organizations like the Pancreatobiliary Pathology Society, can help direct resources towards research and clinical care efforts. Thursday, November 17 is World Pancreatic Cancer Day – an even more focused opportunity to recognize this disease and the numerous efforts to improve the care of those affected. Please remember to “wear purple” and spread the word.
We, the Pancreatobiliary Pathology Society, send our support to the survivors, their families and to everyone who has lost a loved one to this deadly disease. This is also an opportunity to thank our membership for their dedication to improve the clinical practice and management of pancreatic cancer and to foster tissue-based research.
Olca Basturk, President
Pancreatobiliary Pathology Society
Case 2: Quarter 3, 2022
Clinical Details:
A 55-year-old female presented with right upper quadrant abdominal pain and fatigue. She reports a history of a pancreatic tail tumor status-post distal pancreatectomy and splenectomy approximately 25 years ago. The slides from her prior resection were no longer available for review, but per report demonstrated a large (8 cm), “centrally-necrotic” islet cell tumor with negative margins and no lymph node involvement. She had undergone 10 years of surveillance following the distal pancreatectomy with no evidence of recurrence or metastasis. The patient underwent an abdominal CT scan which demonstrated an 8.4 cm mass within the right lobe of the liver with occlusion of the right hepatic vein. The mass was described as mixed cystic and solid and radiologically the concern was for a mucinous cystic neoplasm with an associated invasive carcinoma. Per the radiologist, the findings were not typical of metastatic neuroendocrine tumor. A somatastatin receptor tracer Ga-68 Dotatate PET/CT scan showed no uptake in the liver lesion. As she had no evidence of other liver lesions or extra-hepatic disease, she was recommended to undergo an extended right hepatectomy.
See figures and answer here: Case 2: Quarter 3, 2022
Message from the President
Dear Pancreatobiliary Pathology Society Members,
Despite all the challenges of the COVID19 pandemic, PBPath Society remained very productive last year, thanks to the members of the committees who worked extremely hard to strengthen the existing activities and to bring new initiatives to our organization. I’d like to share with you a few items:
PBPath Society participated in the annual CAP meeting in Chicago, IL in September 2021. Dr. Michelle Reid and I presented the society’s first official course titled “EUS-Guided and “SpyBite” Biopsies of Pancreatic and Biliary Tract Lesions (FNA versus Biopsy)”. This course is scheduled to be repeated at the next annual CAP meeting in October 2022.
The first joint virtual course organized by collaboration of PBPath Society and PathCast was a 2-day course held in January 2022. A total of eight international speakers presented a range of topics covering various aspects of pancreatobiliary pathology. The course was a huge success and was received more than 40,000 in multiple platforms including PBPath.org, YouTube, and Facebook. If you have not attended the course yet, it is still available on our website for virtual viewing (https://pbpath.org/pbps-pathcast-2022/).
Our annual Companion Society Meeting returned to the in-person format at the annual USCAP meeting in Los Angeles, CA in March, 2022. The featured theme “Clonal Evolution of Pancreatobiliary Neoplasms” was received extremely well. I want to thank our speakers, Drs. Yoh Zen, Elizabeth Thompson and David Klimstra for their excellent educational talks, our moderators Drs. Klimstra and Allende for hosting the Q&A session, and you, our members, for your record attendance.
At our annual business meeting, which followed the companion session, we welcomed many new members and presented the PBPath Society abstract award to Dr. Burcin Pehlivanoglu, for her research presentation entitled “TPPP-BRD9 Fusion-Related Gallbladder Carcinomas are Associated with Intracholecystic Neoplasia, Neuroendocrine Carcinoma and a Distinctive Small Tubular-Type Adenocarcinoma Commonly Accompanied with Syringomatous Pattern” (congratulations Dr. Pehlivanoglu!). The official minutes of the Business Meeting can be found on the PBPath Society website (https://pbpath.org/business-meeting-minutes/).
I am also excited to announce that Archives of Pathology and Laboratory Medicine recently published another special section based on the talks given in our previous Companion Society Meeting at USCAP in 2020. I would like to thank Drs. Michelle Reid, David Klimstra, Irene Esposito, and Jing-Young Jang, for their excellent review articles (Arch Pathol Lab Med March 2022 Volume 146 Issue 3; https://meridian.allenpress.com/aplm/issue/146/3)
The Working Groups have been productive as well and published 2 articles:
Dhall D, Shi J, Allende DS, Jang KT, Basturk O, Adsay V, Kim GE. Towards a More Standardized Approach to Pathologic Reporting of Pancreatoduodenectomy Specimens for Pancreatic Ductal Adenocarcinoma: Cross-continental and Cross-specialty Survey from the Pancreatobiliary Pathology Society Grossing Working Group. Am J Surg Pathol. 2021; 45(10):1364-1373.
Wang H, Chetty R, Hosseini M, Allende DS, Esposito I, Matsuda Y, Deshpande V, Shi J, Dhall D, Jang KT, Kim GE, Luchini C, Graham RP, Reid MD, Basturk O, Hruban RH, Krasinskas A, Klimstra DS, Adsay V; Pancreatobiliary Pathology Society. Pathologic Examination of Pancreatic Specimens Resected for Treated Pancreatic Ductal Adenocarcinoma: Recommendations from the Pancreatobiliary Pathology Society. Am J Surg Pathol. 2022; 46(6):754-764.
Finally, our Challenging Case Series, kindly edited by Dr. Rondell Graham, was created for the review of interesting and challenging pancreatobiliary cases in real time. The first case has already been published and can be found on our website (https://pbpath.org/welcome-to-pbps-challenging-cases/). Please keep an eye on our website for detailed discussion of this, and future cases.
I would like to thank the amazing members of the PBPath Society who are dedicated to the growth of our Society and have worked hard to make these accomplishments a reality! Several additional exciting opportunities for PBPath Society to increase our outreach and be impactful is already being explored; as these plans mature, we will share news about these events.
I am honored to have been elected President of the PBPS and I am proud to carry on the tradition of fostering excellence and collaboration in education, research, and the clinical practice of pancreatobiliary pathology around the world.
– Olca Basturk, MD
The PBPS is seeking a new Journal Watch Committee Member
The PBPS journal watch (JW) is seeking a new committee member to join our team for a term of 3 years. The JW is posted every 2 months and includes articles to be highlighted from the most relevant journals in pancreatobiliary pathology. The JW is a valued educational tool among our community and a great way to network with others in the field.
Interested PBPS members should send CV to info@pbpath.org by June 8, 2022. Applicants must be paid members of the Pancreatobiliary Pathology Society.
Daniela Allende, MD MBA, PBPS JW Editor
USCAP2022 highlights
Pancreatobiliary Pathology Society Best Abstract Award of USCAP2022 goes to Dr. Burcin Pehlivanoglu.
Congratulations to Dr. Burcin Pehlivanoglu, of Dokuz Eylul University, who was awarded the Pancreatobiliary Pathology Society’s Best Abstract at USCAP 2022! Dr. Pehlivanoglu’s winning abstract is entitled “ TPPP-BRD9 Fusion-Related Gallbladder Carcinomas are Associated with Intracholecystic Neoplasia, Neuroendocrine Carcinoma and a Distinctive Small Tubular-Type Adenocarcinoma Commonly Accompanied with Syringomatous Pattern.” Dr. Pehlivanoglu was presented the award at USCAP 2022 by Drs. Reid and Klimstra.
The authors for this abstract are listed below:
Burcin Pehlivanoglu, Dokuz Eylul University (Primary Presenter)
Jill Koshiol, National Cancer Institute
Scott Lawrence, Division of Cancer Epidemiology and Genetics, National Cancer Institute
Juan C Araya, Universidad de La Frontera
Serdar Balci, Independent Consultant
Jesper B Andersen, University of Copenhagen
Catterina Ferreccio, Pontifica Universidad Católica de Chile
N. Volkan Adsay, Koç University Hospital
Abstract Award in USCAP 2022
Pancreatobiliary Pathology Society Abstract Award
Dear members of the PBPS,
The PBPS is now accepting applications for this year’s PBPS Abstract Award. This award will go to a pathology trainee with an abstract (poster/platform) in pancreatobiliary pathology presented at the 2022 annual USCAP meeting. Submitted abstracts will be evaluated for originality, scientific merit and presentation, and the winner will receive a $500 prize. At least one author should be a PBPS member. Trainees are strongly encouraged to apply.
The deadline for submission of Award applications is February 15, 2022.
Please email your completed abstract in Word format along with the information below to the education committee chair Dr. Michelle Reid (michelle.reid@emory.edu).
Name:
Training Institution:
Position:
PGY Year:
Date/Time of Presentation:
Abstract Name:
Poster Number (if applicable):
Case 5: Quarter 4, 2021
Clinical Details:
A 63-year-old male with past medical history that includes hyperparathyroidism presented with ongoing left hip pain. Evaluation of the etiology of his pain revealed an incidental mid-abdominal mass on lumbar spine MRI. A dedicated CT scan confirmed the presence of a solid, well-demarcated ovoid peripancreatic mass measuring 11 cm. A CT-guided needle biopsy was performed.
See figures and answer here: Case 5: Quarter 4, 2021
Membership Renewal and Membership Application
Dear pancreatobiliary pathology enthusiasts. We would like to ask all members to update their information and renew their memberships. To renew your membership please click here.
You may reset your password here: Password Reset
If you want to apply for membership please click here.
If you experience any problems please contact us.
The Pancreatobiliary Pathology Society is seeking new Committee Members.
The PBPath Website/Membership committee is seeking new committee members to join our team, for a term of 3 years.
The website/membership team member(s) will help the Pancreatobiliary Pathology Society maintain and expand our membership, post updates to our website, and send newsletters to our members. Experience with WordPress and/or HTML is a plus, but not required.
The ideal candidates possess a willingness to learn and a team-player mentality.
Interested PBPath members should send CV to info@pbpath.org. Successful committee members must be active members of the Pancreatobiliary Pathology Society.
The Pancreatobiliary Pathology Society Executive Committee
Case 4: Quarter 3, 2021
Clinical details:
A 2-year-old-baby presented as a transfer from an outside hospital (OSH) due to concerns for possible acute cholecystitis. The patient has a history of abdominal pain for the last 2 weeks. The laboratory tests from the OSH were notable for leukocytosis. An abdominal CT scan showed a thickened gallbladder wall with numerous polypoid, non-mobile lesions. Eventually, the patient underwent laparoscopic cholecystectomy.
See figures and answer here: Case 4: Quarter 3, 2021
Case 3: Quarter 2, 2021
Clinical details:
A 50-year-old woman with no significant past medical history presented with abdominal pain and a syncopal episode. Abdominal MRI showed a multicystic mass with a significant solid component in the pancreatic tail, measuring 2.2 cm in the greatest dimension. A fine-needle biopsy of the lesion was performed.
See figures and answer here: Case 3: Quarter 2, 2021
2021 PBPath Business Meeting agenda/minutes
Pancreatobiliary Pathology Society Members,
Alas, we will not be able to meet in person this year, therefore please find attached the 2021 Pancreatobiliary Pathology Society (PBPS) Annual Business meeting agenda/minutes for your review to learn what PBPS has accomplished: PBPath Business Meeting 2021
Two requests:
1. Listen to our PBPS Companion meeting speakers, submit your questions and attend the LIVE Question and Answer on Tuesday March 16, 2021 11-11:30 AM PST
2. Vote for our new member before March 20, 2021 (will only take 1 minute) https://www.surveymonkey.com/r/7PWVKV5
Can’t wait to see all of you in person next year!
Most appreciatively,
Grace E. Kim
Pancreatobiliary Pathology Society Secretary/Treasurer
USCAP 2021 Companion Society Program
Pancreatobiliary Pathology Society Companion Meeting USCAP 2021
Rondell Graham, MBBS, Mayo Clinic (Moderator)
Michelle D. Reid, MD, MSc, Emory University Hospital (Moderator)
Barbara A. Centeno, MD, H. Lee Moffitt Cancer Center & Research Institute
Vikram Deshpande, MBBS, MD, Massachusetts General Hospital, Harvard Medical School
Günter Klöppel, MD, PhD, Technical University of Munich
Giuseppe Zamboni, MD, University of Verona
Inflammatory Conditions of the Pancreatobiliary Tree
This session includes 1.5 hours of on-demand educational content. This content can be viewed starting March 1. There will also be a live 30-minute Q&A session with the faculty on Tuesday, March 16, from 11:00 AM – 11:30 AM Pacific Time.
Chronic pancreatitis is a complex inflammatory process with rising incidence and prevalence, and no curative treatment for frequently intractable chronic pain. Despite advances in the field, challenges remain in the radiologic, endoscopic and histologic diagnosis, and the distinction of pancreatitis from cancer. Although some specific pathologic subtypes of pancreatitis have been described and characterized in the past decade, many pathologists are still unaware of their existence, clinicopathologic characteristics, management and genetic implications. Pathologists also struggle with formulating diagnoses, reporting terminology, and determining etiology, particularly on small biopsies, fine needle aspirations and bile duct brushings. In the past year alone numerous multidisciplinary international, consensus guideline manuscripts have made new recommendations regarding risk factors, etiology, management (endoscopic, surgical/non-surgical), and histopathology of chronic pancreatitis. The latter was aimed at clarifying the pathologist’s role in diagnosis, histopathologic criteria, standardizing reports, and limiting confusion in reporting and the literature. The Pancreatobiliary Pathology Society executive committee determined the theme, titles, content and speakers for this year’s companion meeting, with a mission to educate surgical and Cytopathologists on recent advances in inflammatory conditions of the pancreatobiliary tree. This year’s meeting will provide a 360-degree expert analysis and update on acute and chronic inflammatory conditions of pancreatobiliary tree, including specific entities acute/alcoholic pancreatitis (Dr. Günter Klöppel), paraduodenal pancreatitis (Dr. Giuseppe Zamboni), IgG4-related (autoimmune) pancreatitis (Dr. Vikram Deshpande), and the cytopathology of inflammatory lesions of the pancreatobiliary tree (Dr. Barbara Centeno).
The program can be accessed by USCAP attendees here:
Continuing Medical Education
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The United States and Canadian Academy of Pathology and the Pancreatobiliary Pathology Society. The United States and Canadian Academy of Pathology is accredited by the ACCME to provide continuing medical education for physicians.
The United States and Canadian Academy of Pathology designates this Other activity (enduring materials and internet live activity) for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Live Q&A Session: Tue, March 16, 11:00 AM – 11:30 AM PT
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Case 2: Quarter 2, 2021
Clinical details:
A 63-year-old man with a history of mixed hyperlipidemia and gallstones underwent cholecystectomy for recurrent episodes of pancreatitis. A follow-up computed tomography (CT) scan revealed an interval increase in the size of an ill-defined, mass-like lesion in the pancreatic head with peripheral enhancement and central necrosis, concerning for malignancy (Figure 1). Endoscopic ultrasound with fine needle aspiration documented a solid/cystic mass and acinar cells on cytology. He underwent pancreaticoduodenectomy.
See figures and answer here: Case 2: Quarter 2, 2021
Message from the President
Pancreatobiliary Pathology Society (PBPS) Members,
We will all remember 2020 as a year filled with challenges and new ways of doing things, and many of our modified processes are spilling into 2021 as well. With the upcoming USCAP meeting being virtual, we have been working to prepare a compelling agenda for our PBPS Companion Meeting, and I am pleased to report that we have a very fine program devoted to the topic of pancreatitis. Our speakers will include Dr. Barbara Centeno (Cytopathology of inflammatory lesions of the pancreatobiliary tree), Dr. Vikram Deshpande (IgG4-related (autoimmune) pancreatitis), Dr. Günter Klöppel (Acute/alcoholic pancreatitis) and Dr. Giuseppe Zamboni (Paraduodenal pancreatitis). The lectures will be prerecorded, so you can listen to them any time after they go live on March 1. Because of the modified format, the session will only be 90 minutes this year. Please access the talks via the USCAP website. There will be a 30 minute live question and answer session, hosted by Michelle Reid, PBPS Education Committee Chair, on Tuesday, March 16 at 2:00 PM Eastern time. You can enter your questions on-line as well, and Michelle will review them with the speakers. We hope this will be a highly interactive Q&A session, and that the virtual format will allow even more participants to hear these lectures.
I also want to remind everyone about the PBPS Abstract Award competition. Our PBPS Education Committee will select the winning abstract for 2021, and the first author will receive a $500 prize. All applications should be submitted no later than 2/15/2021. Please see the PBPS website for details.
In other news, we have recently revamped our Journal Watch feature, kindly edited by Daniela Allende, PBPS Chair of Journal Watch Subcommittee – please keep an eye on our website for updates about excellent publications related to pancreatobiliary pathology.
We truly regret that we cannot gather in person this year – one of the hardest things about the pandemic of course is the restriction on seeing family, friends, and colleagues – but there is a light at the end of the tunnel, and we will look forward to future meetings when we can gather again to share our interests and catch up on our professional lives!
David Klimstra, Pancreatobiliary Pathology Society President
Abstract Award in USCAP 2021
Pancreatobiliary Pathology Society Abstract Award
Dear members of the PBPS,
Happy new year!
The PBPS is now accepting applications for this year’s PBPS Abstract Award. This award will go to a pathology trainee with an abstract (poster/platform) in pancreatobiliary pathology presented at the 2021 annual USCAP meeting. Submitted abstracts will be evaluated for originality, scientific merit and presentation, and the winner will receive a $500 prize. At least one author should be a PBPS member. Trainees are strongly encouraged to apply.
The deadline for submission of Award applications is February 15, 2021.
Please email your completed abstract in Word format along with the information below to the education committee chair Dr. Michelle Reid (michelle.reid@emory.edu).
Name:
Training Institution:
Position:
PGY Year:
Date/Time of Presentation:
Abstract Name:
Poster Number (if applicable):
Comments:
Case 4: Quarter 4, 2020
Clinical History
A 58-year-old woman with no significant past medical history developed left abdominal pain. An abdominal MRI showed an irregular enhancing 4.5 x 4.0 cm pancreatic tail mass that was inseparable from vessels in the splenic hilum. Endoscopic ultrasound-guided fine-needle aspiration showed rare malignant cells, favoring adenocarcinoma. The patient subsequently underwent neoadjuvant therapy with Gemcitabine/Abraxane followed by a distal pancreatectomy, splenectomy, partial omentectomy and removal of surrounding lymph nodes.
See figures and answer here: Case 4: Quarter 4, 2020
Case 3: Quarter 3, 2020
Clinical History
A 38-year-old female with a history of hypertension presented to the emergency department with complaints ofnausea, vomiting, and back pain. MRI showed a T1 hypointense, T2 hyperintense, nonenchancing cystic lesion at the tail of the pancreas, which caused mass effect upon the spleen and stomach. A distal pancreatectomy was subsequently performed. The patient is currently being followed with no evidence of recurrence or malignant transformation.
See figures and answer here: Case 3: Quarter 3, 2020
Message from the President
Dear Colleagues,
I am sad to share news of the death on July 7 in Milan, Italy of Dr. Juan Rosai.
Dr. Rosai was clearly one of the most influential figures in surgical pathology in the last 50 years, whose broad diagnostic expertise was recognized worldwide. For much of his career, he served as a consultant to the international pathology community, providing expert second opinions and making enormous contributions to direct patient care. As a researcher, Dr. Rosai was best known for his work on neoplasms of the thyroid, thymus, and vascular system, but essentially there is no subspecialty area that did not receive his investigative attention. In fact, he wrote many papers on pancreatic neoplasms, and it was his encouragement of me to pursue a case of pancreatic acinar cell carcinoma that led me to the field of pancreatic pathology. Dr. Rosai was among the first to embrace technologies like electron microscopy, immunohistochemistry, and molecular biology to enhance pathologic diagnosis. He was also one of the first pathology leaders to promote digital pathology and predicted the field’s evolution from microscopic to digital pathology many years before it occurred, and he pushed for subspecialization of academic pathology years before it became commonplace – ironic, given that he himself was the quintessential generalist. But perhaps his most lasting contributions were made as a mentor and teacher, roles he took on with great enthusiasm. He fostered the careers of countless trainees, many of whom are now in leadership positions around the world. Recitation of his numerous achievements, awards, and honors can await more formal tributes that will appear in time, but no one can doubt that Juan Rosai achieved as much as any individual can in our field, and his influence has been felt across all subspecialties. A world-renowned surgical pathologist, as well as a treasured friend to many, Dr. Rosai’s generous spirit and ability to build consensus are as much a part of his legacy as his unparalleled expertise. Our thoughts are with his wife, Dr. Maria Luisa Carcangiu, and his children.
David Klimstra
President, Pancreatobiliary Pathology Society
Pancreatobiliary Pathology Society’s Special Section in Archives of Pathology and Laboratory Medicine
Dear Pancreatobiliary Pathology Society Members
I am writing to draw your attention to the newly released Archives of Pathology and Laboratory Medicine (https://archivesofpathology.org/toc/arpa/144/7) which includes a Special Section containing review articles on the topics we presented at our 2019 USCAP Companion Meeting session.
You will find comprehensive and authoritative reviews written by our speakers, Drs. Laura Wood, Laura Tang, Stefano La Rosa, and Huamin Wang, along with selected collaborators. We are particularly pleased and grateful to the Editors of Archives, Drs. Philip Cagle and Donna Hansel, for agreeing to publish a Special Section based on our meeting, and to Managing Editor Katie Giesen, whose assistance was tremendously helpful during the process.
I am also happy to report that we will be publishing a second installment based on the presentations at the 2020 USCAP Companion Meeting, so stayed tuned. Thanks to all who participated in authoring, reviewing, and publishing these reviews, and I hope you all enjoy reading them.
Best wishes, and Stay Safe!
David Klimstra
On behalf of the Executive and Education Committees
Pancreatobiliary Pathology Society
Case 2: Quarter 2, 2020
Clinical details:
A 24-year-old female presented to the emergency department with severe left-sided abdominal pain. CT abdomen/pelvis showed a heterogeneous mass in the tail of the pancreas with multiple metastatic liver lesions and lymphadenopathy. Liver lesion biopsies were attempted and yielded necrotic debris with outlines of atypical cells that were positive for pancytokeratin (AE1/AE3). The patient next underwent a distal pancreatectomy.
See figures and answer here: Case 2: Quarter 2, 2020
USCAP 2020 Highlights
COMPANION SOCIETY HANDOUTS
Cystic and Intraductal Neoplasms of the Pancreatobiliary Tract
Moderators:
Martha Bishop Pitman, Deepti Dhall
Irene Esposito: Non-mucinous Cystic Lesions of the Pancreas
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USCAP2020 highlights
Pancreatobiliary Pathology Society Best Abstract Award of USCAP2020 goes to:
Julia R. Naso, MD/PhD
University of British Columbia
Association of Inflammatory Cell Infiltrates with Signatures of Immunogenicity in Pancreatic Adenocarcinoma
Message from the President
Dear Pancreatobiliary Pathology Society Members,
Happy Winter!
We are gearing up for the annual USCAP meeting! Our Companion Society session will be held on Saturday, February 29th from 7-10 pm in room LACC 502-A. Our annual Business Meeting will immediately follow. This year is the end of the two-year terms for the Executive Committee so we will be presenting the slate for President, Vice President and Secretary Treasurer. Please attend and cast your votes! Also, nominations have been submitted for the PBPath Society Abstract Award and the winner will be announced at the Business Meeting.
Our society has been extremely productive over the past several months. The creation of an excellent program for the Companion Society by our Education Committee is only one of several accomplishments. I am excited to inform everyone that Archives of Pathology and Laboratory Medicine is going to publish review articles sponsored by the PBPath Society. These articles are based on the lectures that were given during our Companion Society Meeting at USCAP 2019. Please keep an eye out for these publications. Our Case of the Quarter Subcommittee remains active and has been providing educational cases for all members to tackle; this past fall, we welcomed 4 new members to the subcommittee: Deyali Chatterjee, Goo Lee, Yue Xue and Zhaohai Yang. Our bimonthly Journal Watch nicely highlights pertinent publications involving the pancreatobiliary tract.
And there is more good news. Because of Serdar Balci’s web-based knowledge and dedication to the society, the Membership/Website Committee, along with the Executive Committee, have appointed Serdar Balci as the official Webmaster for the society – congratulations Serdar on this well-deserved appointment! The PBPath Society is also now accepting ads for job and fellowship postings. The Working Groups have been productive as well: The Cytology group is wrapping-up a multi-institutional study assessing the minimal number of tumor cells required for Ki67 index calculation on pancreas FNA samples using corresponding resections as the gold standard for comparison, and the Neoadjuvant group presented their data at the 2019 USCAP Annual Meeting and is planning to write a consensus paper based on the group’s work. This past fall, PBPath Society members also participated in the ASCP, CAP and European Congress of Pathology annual meetings. Most recently, we’ve been asked to provide input on the ICCR’s draft dataset on carcinoma of the exocrine pancreas (please check your emails as the deadline is February 14th).
Our society continues to be a success because of you, its members! I would like to recognize the following members who continuously contribute time and effort to our society: Olca Basturk, for organizing another stellar USCAP Companion Society session; Serdar Balci for publishing the bimonthly journal watch; Mabel Ko for managing our website and the members of the Executive Committee, Grace Kim, David Klimstra, David Lewin, Volkan Adsay, and Olca Basturk, for keeping everything on track and in order.
The PBPath Society is an international organization that strives to improve the clinical practice of pancreatobiliary pathology by providing an environment of team work and cooperation. As my Presidency comes to an end, it amazes me how much we have accomplished over the past 2 years. None of what we now have would have been possible without such collegial, friendly, and motivated members. I am so happy and so proud that I had the chance to serve as the President of this great society.
– Alyssa M. Krasinskas, MD
Case 1: Quarter 1, 2021
Clinical details:
A 73-year-old female with a history of monoclonal gammopathy of undetermined significance (MGUS) and small fiber peripheral neuropathy was found to have elevated transaminases and alkaline phosphatase (ALP) – ALT 54 U/L (normal range 15-41), AST 66 U/L (normal range 14-54), ALP 322 U/L (normal range 38-126) on routine laboratory testing. Total bilirubin was within normal limits (0.3 mg/dL), and gamma-glutamyl transferase was not performed. Abdominal CT showed diffuse thickening and enhancement of the extrahepatic and central intrahepatic biliary tree with associated areas of narrowing as well as mild intrahepatic biliary ductal dilation. During ERCP, mucus was seen extruding from a gaping papilla, thus clinically a pancreatic main duct intraductal papillary mucinous neoplasm (IPMN) was considered. Bile duct brushing cytology showed atypical cells, which were favored to represent a reactive process. Whipple resection was performed for the suspected IPMN. After the Whipple procedure, she experienced an initial improvement in laboratory values. A rheumatologic evaluation was negative, including autoimmune (ANA, ANCA, SSA, SSB, anti-dsDNA, and anti-mitochondrial antibodies), infectious (viral hepatitis, HIV), and immunoglobulin (SPEP, quantitative immunoglobulins, including repeated IgG4) testing. Since her initial improvement, follow-up MRI showed new and worsening areas of stricture and continued thickening and enhancement of her biliary tree. Since optimizing her immunosuppressive regimen, her disease has remained stable.
See figures and answer here: Case #1: Quarter 1, 2021