General Session 1: Molecular Pathology Testing in Solid Tumors: An overview and consideration of tissue requirements for various testingPresented by Noel A. Brownlee, MD, Upstate Pathology, Bon Secours Saint Francis Health SystemPersonalized health care is fast becoming a reality in oncology treatment planning. While morphologic evaluation of tissue by routine H&E stained tissue sections is still invaluable in establishing a diagnosis, immunohistochemistry and molecular pathology testing are proving to offer significant insight into potential therapeutic targets in cancer patients. In this presentation, participants will learn about various molecular pathology and immunohistochemistry testing being employed in several different solid tumor types including lung, breast, and gastrointestinal cancers. For example, in lung cancer patients, several targets (epidermal growth factor receptor gene mutations and ALK gene rearrangements, among others), have revolutionized treatment in these patients. In addition, in current practice, histology laboratories and pathologists are called upon to do increasing numbers of in-house or send-out testing on smaller tissue samples. In this session, we will discuss tissue considerations for various clinical scenarios related to personalized medicine testing.

General Session 2: CAP & NSH Uniform Labeling of Slides & Blocks in Surgical Pathology – An UpdatePresented by Vinnie Della Speranza, MS, HTL(ASCP), Anatomic Pathology Manager, Medical University of South CarolinaThe College of American Pathologists (CAP) and the National Society for Histotechnology (NSH) have partnered to produce guidelines for the Uniform Labeling of Slides and Blocks in Surgical Pathology. This session will explain the origins of the project and the conclusions the committee has drawn based on its research and surveying.

General Session 3: Ex Vivo Tissue Test Systems: Challenges in HistologyPresented by Karen J.L. Burg, PhD, Director, Institute for Biological Interfaces of Engineering, Clemson UniversityTissue engineering is the development of a biological tissue substitute or model by combining cells with a biomaterial scaffold. The early concept of engineering tissue for reconstructive purposes, i.e. to replace or enhance a damaged tissue or organ, has evolved to include the construction of bench-top test tissue systems for therapeutic development, developmental cell biology studies, and disease prevention. Regardless of the end goal, the viability of a tissue engineered product relies on cell-biomaterial interaction and the design of an appropriate 3D microenvironment. The fields of histology and pathology have been and will continue to be inundated with questions associated with the design of engineered tissues, the analysis of biocompatibility of cellular biomaterials, and the assessment of cell-material relationships. This presentation will include an introduction to 3D tissue test system biofabrication, the potential for personalized medicine, as well as the challenges and limitations associated with building a benchtop model system.

General Session 4: H&E Staining Quality Improvement - Using a Quality Control Slide Does Not Guarantee a Quality Stain Presented by Janet Tunnicliffe, MLT ART, Anatomic Pathology Regional Laboratory Scientist, Fraser Health Authority The H&E is the most utilized stain in histology. A control slide is used to assure stain quality however the control does not always tell the whole story. In this workshop we will examine factors involved in assuring optimum stain quality.

Workshop A: Breast Cancer: A Discussion of the Epidemiology, Diagnosis, and Technical Challenges of Breast Tissue Workups in the Histology LabPresented by Vinnie Della Speranza, MS, HTL(ASCP), Anatomic Pathology Manager, Medical University of South CarolinaThe modern clinical histology laboratory is often under great pressure to provide a diagnosis on breast samples as quickly as possible. This is largely due to the emotional nature of breast cancer and the patient’s anxiety when a lesion is discovered. The lack of real progress in survival rates strikes fear in all of us. Unfortunately for the lab, breast samples pose particular challenges that make rapid turnaround even more difficult and today, prognosis and therapeutic decisions rest largely on information generated from the biopsy sample. Less than optimal handling could mislead the oncologist and prevent a patient from receiving treatments that might be beneficial. The evolution of diagnostic and treatment strategies as they impact the laboratory will be discussed along with the technical challenges of ensuring that maximum diagnostic and prognostic information is achieved from the sample. The most current regulations for the handling of breast specimens will be reviewed along with available options for prognostic markers staining.

Workshop B: RECALL! The Histology and Pathology of Metal-on-Metal Hip ReplacementsPresented by Melinda Harmon, PhD, Assistant Professor and Pooja Panigrahi, MS, Graduate Student, Bioengineering Department, Clemson UniversityPeri-prosthetic osteolysis is an adverse biological response to particulate debris caused by wear and it is the primary factor limiting the longevity of joint replacements. Over the past 15 years, efforts to reduce wear and osteolysis have led to advanced biomaterials and new prosthesis designs for hip replacements. In particular, cobalt-chrome biomaterials used for metal-on-metal articular bearings provided for hip prosthesis designs with large diameter femoral heads, which are considered beneficial to the surgical techniques and patient outcomes. The regulatory pathway for these new biomaterials and designs overwhelmingly relied on “substantial equivalence” rather than clinical trials, and surgeons around the world rapidly introduced these “next generation” metal-on-metal prostheses into clinical practice. However, there were unexpected challenges, as evidenced by extraordinarily high failure rates for some designs (~15% at 5 years) and descriptions of “pseudo-tumors” at the time of revision surgery. Regulatory and legal challenges soon followed as the FDA announced a major recall of nearly 100,000 metal-on-metal hip prostheses in 2010 and a 2013 class action lawsuit involving approximately 8000 American patients required $2.5 billion in settlement charges. The purpose of this workshop is to present the histological evidence and pathology associated with the failures of these modern metal-on-metal hip replacements. We will use clinical case examples to achieve the following learning objectives. (1) Understand the surgical and bioengineering rationale supporting the use of metal-on-metal hip replacements, including hip resurfacing and other modern design concepts. (2) Review the semi-quantitative grading schemes and analytic techniques used to characterize the clinical pathology and generate scientific evidence. 3) Recognize tissue reactions to wear of the biomaterials commonly used in hip replacement, differentiating reactions to polymeric debris (i.e. macrophage response) and metallic particulate and corrosion products (i.e. lymphocytic response).

Register today for the 2 day Carolina Symposium sponsored by the National Society for Histotechnology, the South Carolina Society of Histotechnology and the North Carolina Society of Histotechnology. This two day collaboration brings the best of the three organizations offering a fantastic educational program and an Exhibit Fair for one low price! Attendees have the opportunity to earn up to 10.5 continuing education credits.

Carolina Symposium2 Day

Carolina Symposium2 Day

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Hotel Information:

Embassy Suites Greenville | Golf Resort & Conference Center 670 Verdae Blvd | Greenville, SC 29607

Registrants are responsible for hotel / travel arrangements. We have secured a small block of rooms at the discounted group rate of $119.00 plus applicable taxes. To make reservations call 1-800-EMBASSY or the hotel directly at 864-676-9090 and inform the agent that you are with the National Society for Histotechnology (NSH Carolina Symposium). Hotel Deadline is March 13, 2014.

I Have To Know All That For the Exam! Presented by Shane Jones, HT(ASCP), Program Director, Baptist Health School of HistotechnologyStudying for the ASCP Board of Registry Exam is a huge undertaking. That difficulty is increased even more when you are doing it on your own. The amount of time and discipline it takes can be overwhelming. 6 hours is nowhere near adequate to cover what you need to study for the Board of Registry Exam. In this workshop we will do our best to cover the same subject matter that I use for my students each year. We will cover the information with the 5 subcategories of the Board of Registry Exam in mind. The subject matter within these subcategories will include: instrumentation and its maintenance used in the histology lab, safety issues and guidelines that are set up by various government agencies, laboratory math and chemistry basic level, the four major tissue types and eighteen different organs will be microscopically identified, chemicals that are used in tissue processing (fixatives, dehydrating agents, clearing agents, and infiltrating medias) will be identified and their advantages and disadvantages will be discussed, embedding and microtomy methodologies and troubleshooting will be addressed, the H & E stain, the 4 methods of decalcification and methods for testing endpoint, and finally we will address special stains (their mode of action, components and their functions, what they are recommended for, and results of each).

Getting to the Meeting: Located in the foothills of the Blue Ridge Mountains in Greenville, SC, Embassy Suites Greenville Golf Resort & Conference Center offers all-suite comfort and beautiful surroundings. The hotel is minutes from downtown Greenville, Greenville-Spartanburg International Airport and Clemson University. The hotel features complimentary in room internet, a par-72 championship golf course, indoor & outdoor pool and a complimentary shuttle to local attractions. For those driving free self-parking is available at the hotel.

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Workshop C: What Happens When Automation FailsPresented by Tonia Crook, BSBM, HT(ASCP), Executive Director, Provia Diagnostics (Session Sponsored by Cancer Diagnostics)This presentation is about what the histologist can do when the automatic process fails. This can include automatic tissue processors, automatic stainers and coverslippers. The younger generation of histologists is use to an electronic, automated existence; however, automated equipment can sometimes fail. What to do? Don’t panic! This workshop will teach you how to troubleshoot the equipment and retrieve the specimen in a safe manner. You will then learn the steps necessary to manually complete the specific process. The importance of chemistry in histology, safety and order of the histological process will be emphasized. Laboratory fundamentals that may not be used on a daily basis will be reinforced.

Workshop D: IHC Troubleshooting - Simple Solutions to Unique Problems Presented by Janet Tunnicliffe, MLT ART, Anatomic Pathology Regional Laboratory Scientist, Fraser Health AuthorityPoor staining, non-specific staining, no staining, is it always related to the antibody? Technical knowledge and practical skills are often challenged when something out of the ordinary happens; what do you do when you have tried all the common solutions and the problem continues. This workshop will demonstrate some unique issues that were resolved by looking beyond the antibody and searching for the root cause.

Workshop E: Microsatellite Instability in Colorectal CancerPresented by Beth Sheppard, HT(ASCP), Director, Global Standard, Ventana Medical Systems (Session Sponsored by Ventana Medical Systems)Microsatellite Instability (MSI) is caused by the loss of DNA mismatch repair activity. MSI is detected in about 15% of all colorectal cancers and 3% of these associated with Lynch Syndrome. Immunohistochemistry (IHC) is a corresponding testing strategy used to evaluate the expression of the MLH1, MSH2, MSH6, and PMS2 proteins in HNPCC/Lynch syndrome related cancers. Loss of expression of 1 or more of these proteins within the tumor is helpful in identifying which corresponding gene(s) to target for mutation analysis. This lecture will discuss the presence and loss of these expressions and the corresponding diagnosis.

Workshop F: Advances in Digital PathologyPresented by Luke Benko, Sales Manager, Cytogentics & Ariol, Leica Aperio ePathology, Leica Biosystems (Session Sponsored by Leica Biosystems)Pathology continues to evolve and change with digital technology. This new technology allows for fast acquisition, sharing and retreaval of imaged slides. Unbiased, standardized analysis may be performed using a multitude of assay protocols, some with FDA 510 Clearances. Slides may then be safely stored and restored from digital databases available to anyone on a network. All patient data can be compiled in one location, accessible by integrated health care providers. Eliminating the need for glass curriers and reimbursed analysis provide financial incentives to utilize digital slide scanning.

Workshop G: The Purple Book: GHS Classification & LabelingPresented by Chad McMahan, MBA, HT(ASCP), Histology Laboratory Manager, Clemson UniversityThe Purple Book is a globally harmonized system (GHS) of classification and labeling of chemicals that has been recently developed by many different companies and international organizations (including our own country’s OSHA Hazard Communication Standard). So what does this mean for lab safety? At the end of December 2013 a change will begin appearing from the MSDS (material safety data sheet) format to a universal SDS (Safety Data Sheet) and by June 1st, 2016 all SDS’s will be the same format around the world! This workshop will cover the differences between the old and new format and a new SDS will be included in the handout. In addition, the attendee will be provided with a list of helpful safety email links along with the viewing of a real and dramatic video of “what NOT to do in the lab”.

Workshop H: Antibody ChallengePresented by Jacob Wilson, Technical Consultant, Cell Marque (Sponsored by Cell Marque)Get a glimpse at how IHC comes into play for a patient. This workshop will be a fun, interactive look at how IHC can be used by pathologists. The discussion will be geared for an audience with a basic to intermediate level of IHC understanding. First we will take a brief look at how to interpret a panel of antibodies and review the significance of their use. We will move on to explore some of the basic panels and the markers that are involved. After we have established a solid understanding of basic panels, we will widen our exploration to include some of the more advanced algorithms as well. At this point we will begin the best part, with interactive participation of the audience. We will present real life scenarios accompanied with various clues and staining results, and allow the audience to use their newly acquired knowledge of panel usage to decide what markers might be helpful. At the conclusion of this talk, the audience will have seen for themselves how important IHC can be, and also how panels can be a great tool to assist pathologists with finding an accurate diagnosis.Falls Park, Greenville

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Thursday, April 35pm – 8pm Check In

Friday, April 47:30am Registration & Continental Breakfast8:30am – 10:00am General Sessions 1

Molecular Pathology Testing10:00am – 10:30am Refreshment Break 10:30am – 12:00pm Workshops A&B12:00pm – 1:15pm Grab & Go Lunches – Join in at the

NC/SC Society Business Meeting1:15pm – 3:45pm Exhibit Fair Open1:45pm – 3:05pm General Session 2 & 3

CAP& NSH Uniform Labeling of Slides & Blocks – An Update Ex Vivo Tissue Test Systems: Challenges in Histology

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3:05pm – 3:45pm Refreshment Break3:45pm – 5:15pm Workshops C&D5:15pm – 6:15pm Networking Reception in Exhibit Hall

Saturday, April 58:00am Continental Breakfast8:30am – 10:00am Workshops E & F8:30am – 4:15pm Board of Certification HT(ASCP)

Readiness Course (prereg required)10:00am – 11:30am Exhibit Fair Open11:30am – 1:00pm Award Luncheon in Exhibit Hall1:00pm – 2:30pm General Session 4

H&E Staining Quality Improvement2:30pm – 2:45pm Refreshment Break2:45pm – 4:15pm Workshops G & H

> Schedule at a Glance <

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Send in Your Registration! Fax: (443) 535-4055 | Email: histo@nsh.org | Via Mail: NSH, 8850 Stanford Blvd, Suite 2900, Columbia, MD 21045

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Select Registration Type:Full Symposium (both days)

Member ($225.00) Non Member ($299.00) Student Member ($169.00)

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One Day Pass (one day) Member ($139.00) Non Member ($259.00) Friday Saturday

HT Readiness Course Only (Saturday, April 5th) HT Readiness Course Only ($139.00)

2 Day Carolina SymposiumApril 4 - 5, 2014 | Embassy Suites Greenville Golf Resort, Greenville, SC Earn up 10.5 hours of continuing education credit!

8850 Stanford Blvd. Suite 2900Columbia, MD 21045PH. 443-535-4060 | www.nsh.orgCarolina Symposium Day

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Histotechs/Cytotechs in Clinical, Veterinary & Research Settings Lab Supervisors & Managers Anyone involved in the collection, processing & evaluation of tissue samples

Who Should Attend?

Date: April 4-5, 2014

Place: Embassy Suites

Greenville Golf Resort,Greenville, SC

HT Eligible? Don’t Miss the Full Day HT Readiness Course on April 5th!