Short Course #14 - Thyroid Molecular Cytopathology According to the 3rd Edition of The Bethesda System

Course overview

The impact of molecular testing on thyroid cytology is well recognized. By probing genomic alterations, the major molecular test platforms have the potential to clarify the biologic nature of indeterminate thyroid nodules. This session will illustrate the key concepts and use a practical case-based approach to address the following topics. Molecular changes in thyroid neoplasia Overview of molecular testing platforms in thyroid cancer Benign Call Rate (BCR) and Molecular-Derived Risk of Malignancy (MDROM) and their application to thyroid cytopathology Cancer prognostication using "Molecular Risk Groups" (MRGs) Emerging role of molecular testing for Suspicious for Malignancy (Bethesda-V) cases and false negative molecular results Interpretation of a "negative" molecular result and importance of surveillance even for MT-negative cases Deviation from the usual genotype-phenotype expectation (e.g. RAS-like alterations and follicular-patterned neoplasms); usefulness of MT to refine surgical planning Use of molecular testing results to refine a nodule's risk of adverse clinical outcomes and guide decisions regarding extent of surgery Target Audience This educational activity is designed for pathologists, cytopathologists, cytotechnologists, students and other members of the cytopathology community. Learning Objectives Provide updates on the characteristics and role of molecular testing within the framework of TBSRTC, 3rd edition. Develop deeper insights into molecular testing results to improve the pre-surgical risk stratification of thyroid nodules. Explain certain molecular profiles through case examples that have significance for diagnostic, prognostic, theranostic, and quality assurance purposes. Presenter(s): N. Paul Ohori, MD Michiya Nishino, MD, PhD