The Pancreatobiliary Pathology Society (PBPS) would like to thank Alain C. Borczuk, MD, and the Archives of Pathology & Laboratory Medicine for again highlighting our society by publishing 4 review articles based on the presentations at the PBPS companion society symposium at the 2020 United States and Canadian Academy of Pathology (USCAP) meeting. Our mission is to educate surgical pathologists and cytopathologists on the importance of the advances in this complex area and hopefully transform the way we practice pancreatobiliary pathology. The PBPS fosters excellence and international collaboration in education, research, and the global practice of pancreatobiliary pathology. PBPS became an official society in 2016 and a USCAP companion society in 2018, but the sharing of knowledge, enthusiasm, and ideas in pancreatobiliary pathology started more than 20 years ago as an annual “Pancreas Club” luncheon held during the USCAP meeting, which grew over the years and became the PBPS. The first advisory council members of the Pancreas Club were Volkan Adsay, MD; Ralph Hruban, MD; David Klimstra, MD; Günter Klöppel, MD; and Giuseppe Zamboni, MD. Thanks to their dedication to pancreatobiliary pathology and contagious enthusiasm, many other pathologists interested in pancreatobiliary pathology were attracted to join and motivated the transformation into the official 501c3 society that it is today (PBPath.org).
The 2020 PBPS Companion Society Symposium was entitled “Cystic and Intraductal Neoplasms of the Pancreatobiliary Tract” and consisted of 5 outstanding presentations entitled (1) “Preoperative Molecular Assessment of Pancreatic Cysts and Intraductal Lesions,” (2) “Cytologic Assessment of Cystic/Intraductal Lesions of the Pancreatobiliary Tract,” (3) “Mucinous Cystic and Intraductal Neoplasms of the Pancreatobiliary Tract,” (4) “Nonmucinous Cystic Lesions of the Pancreas,” and (5) “Management Algorithms for Pancreatic Cysts and Intraductal Neoplasms: The Surgeon's Perspective.” These topics represented a 360-degree expert evaluation of cystic and intraductal pancreatobiliary lesions and were given in the same stepwise manner in which they are often encountered, from the cytomorphologic and molecular characteristics to their histomorphology, and finally to management from a surgeon's perspective.
Four of the presentations from the 2020 companion meeting have been converted into review articles in this issue of Archives of Pathology & Laboratory Medicine. In the first article, Michelle Reid, MD, MS, reviews the cytologic features of cystic and intraductal pancreatobiliary tract lesions. Dr Reid emphasizes the use of an integrated, multidisciplinary approach for the evaluation of cystic/intraductal pancreatobiliary tract lesions, incorporating clinical, radiologic, and cytologic findings with chemical and molecular cyst fluid analysis as well as ancillary studies for definitive diagnosis and classification (and, where applicable, grading) of mucinous and nonmucinous cystic lesions. She also describes the cytologic features of tumoral intraepithelial neoplasms, intraductal oncocytic papillary neoplasms (IOPNs), intraductal tubulopapillary neoplasms (ITPNs), and intraductal papillary neoplasm of bile duct (IPNB), which may be sampled by bile duct brushing or fine-needle aspiration biopsy. The second article examines recent advances in mucinous cystic and intraductal neoplasms of the pancreatobiliary tract and is written by David Klimstra, MD, along with his colleague Kerem Ozcan, MD. In this article Drs Klimstra and Ozcan explore the clinicopathologic, genetic, and prognostic features of cystic and intraductal mucinous neoplasms of the pancreas, including mucinous cystic neoplasms and pancreatic intraductal neoplasms, intraductal papillary mucinous neoplasm (IPMN), IOPN, and ITPN. Additionally, the histologic features of preinvasive mass-forming neoplasms of the bile duct IPNB, IOPN, and ITPN are described, along with similarities and differences compared with their pancreatic counterparts. Recently described aspects of morphology, grading, classification, and genomic alterations in these neoplasms are emphasized. The third article is on nonmucinous cystic lesions of the pancreas and is by Irene Esposito, MD, and her colleague Lena Haeberle, MD. In this article Drs Esposito and Haeberle examine the spectrum of nonmucinous cystic lesions of the pancreas and their different biological behaviors. They review serous cystic neoplasms, solid-pseudopapillary neoplasms, cystic neuroendocrine tumors, and pancreatitis-associated pseudocysts, and discuss their epidemiology and clinical and gross features as well as their histomorphology, immunohistochemistry, molecular profile, and prognostic associations. The fourth and final article is entitled “Management Algorithms for Pancreatic Cystic Neoplasms: The Surgeon's Perspective” and is written by Jin-Young Jang, MD, PhD, along with his colleague Hyeong Seok Kim, MD. Drs Jang and Kim review the current status of pancreatic cystic neoplasms including IPMNs, their epidemiology, malignancy risk, and treatment-related factors. They also discuss optimal management algorithms for IPMNs, which require thoughtful assessment to determine the indication for resection. The use of nomograms, surveillance, and other management strategies in customizing IPMN management is explored, along with more tailored approaches to surgical intervention versus surveillance.
We are extremely proud of our society and the continued contributions of its members to the field of pancreatobiliary pathology. We hope that you will enjoy these review articles exploring a unique, 360-degree (cytopathologist's, surgical pathologist's, and surgeon's) perspective on cystic and intraductal neoplasms of the pancreatobiliary tract.
David S. Klimstra, MD, serves as the president of the Pancreatobiliary Pathology Society. He is a world-renowned gastrointestinal, hepatic, and pancreatobiliary pathologist who serves as a professor of pathology and laboratory medicine at Weill Cornell Medicine and chair of the department of pathology and attending pathologist at Memorial Sloan Kettering Cancer Center (MSK), both in New York, New York. He graduated from Yale University School of Medicine (New Haven, Connecticut) and trained in anatomic pathology at Yale New Haven Hospital under the mentorship of Juan Rosai, MD. Following residency, Dr Klimstra moved with Dr Rosai to Memorial Sloan Kettering, where he completed a fellowship in oncologic and consult pathology before joining the faculty in 1992. He rose through the ranks to full attending and professor and served as the chief of the surgical pathology service and then chair of the department in 2012. Dr Klimstra is an internationally recognized expert on the pathology of pancreatic, hepatobiliary, neuroendocrine, and gastrointestinal neoplasia. He has published more than 500 scientific articles on these topics and has also authored more than 100 reviews, book chapters, and textbooks, including 4 Armed Forces Institute of Pathology tumor fascicles and numerous sections for World Health Organization (WHO) Blue Books. He currently serves as a member of the expert editorial boards for the WHO on gastrointestinal and endocrine tumors. He has lectured worldwide and has mentored dozens of gastrointestinal pathology fellows over the years, many of whom are now recognized expert pathologists as well. Based on his secondary interests in digital pathology and artificial intelligence, Dr Klimstra cofounded the pathology artificial intelligence company Paige.AI, and earlier this year he retired from his position as chair at MSK to serve as the chief medical officer for Paige. Dr Klimstra is a section editor for the Archives of Pathology & Laboratory Medicine.
David S. Klimstra, MD, serves as the president of the Pancreatobiliary Pathology Society. He is a world-renowned gastrointestinal, hepatic, and pancreatobiliary pathologist who serves as a professor of pathology and laboratory medicine at Weill Cornell Medicine and chair of the department of pathology and attending pathologist at Memorial Sloan Kettering Cancer Center (MSK), both in New York, New York. He graduated from Yale University School of Medicine (New Haven, Connecticut) and trained in anatomic pathology at Yale New Haven Hospital under the mentorship of Juan Rosai, MD. Following residency, Dr Klimstra moved with Dr Rosai to Memorial Sloan Kettering, where he completed a fellowship in oncologic and consult pathology before joining the faculty in 1992. He rose through the ranks to full attending and professor and served as the chief of the surgical pathology service and then chair of the department in 2012. Dr Klimstra is an internationally recognized expert on the pathology of pancreatic, hepatobiliary, neuroendocrine, and gastrointestinal neoplasia. He has published more than 500 scientific articles on these topics and has also authored more than 100 reviews, book chapters, and textbooks, including 4 Armed Forces Institute of Pathology tumor fascicles and numerous sections for World Health Organization (WHO) Blue Books. He currently serves as a member of the expert editorial boards for the WHO on gastrointestinal and endocrine tumors. He has lectured worldwide and has mentored dozens of gastrointestinal pathology fellows over the years, many of whom are now recognized expert pathologists as well. Based on his secondary interests in digital pathology and artificial intelligence, Dr Klimstra cofounded the pathology artificial intelligence company Paige.AI, and earlier this year he retired from his position as chair at MSK to serve as the chief medical officer for Paige. Dr Klimstra is a section editor for the Archives of Pathology & Laboratory Medicine.
Michelle Reid, MD, MS, is the chair of the education committee for the Pancreatobiliary Pathology Society (PBPS) and cochair of the PBPS Cytopathology Working Group. She is an internationally known pancreatobiliary cytopathologist, professor of pathology, director of cytopathology, and director of the cytopathology fellowship program at Emory University in Atlanta, Georgia. Dr Reid earned her MBBS and doctorate of medicine (DM, part I) in anatomic pathology at the University of the West Indies in Kingston, Jamaica. She went on to complete a residency in anatomic and clinical pathology at the Mount Sinai School of Medicine in New York, New York, followed by a cytopathology fellowship at the Memorial Sloan Kettering Cancer Center in 2005. In 2005 Dr Reid joined the faculty of the Medical College of Georgia in Augusta, where she served as director of cytopathology. Since moving to her current position at Emory in 2010, Dr Reid has given multiple national and international courses and talks on pancreatobiliary cytopathology at United States and Canadian Academy of Pathology (USCAP), College of American Pathologists (CAP), American Society of Cytopathology (ASC), American Society of Clinical Pathology, and European Congress of Cytology meetings. Dr Reid has authored more than 140 peer-reviewed publications and book chapters, including chapters in the WHO Classification of Tumours of the Digestive System as well as the soon-to-be published WHO International System for Reporting Pancreaticobiliary Cytopathology, for which she also serves as an expert editorial board member. Dr Reid has served on multiple USCAP, CAP, and ASC committees and serves as a section editor for the Archives of Pathology & Laboratory Medicine as well as on editorial boards of other peer-reviewed scientific journals.
Michelle Reid, MD, MS, is the chair of the education committee for the Pancreatobiliary Pathology Society (PBPS) and cochair of the PBPS Cytopathology Working Group. She is an internationally known pancreatobiliary cytopathologist, professor of pathology, director of cytopathology, and director of the cytopathology fellowship program at Emory University in Atlanta, Georgia. Dr Reid earned her MBBS and doctorate of medicine (DM, part I) in anatomic pathology at the University of the West Indies in Kingston, Jamaica. She went on to complete a residency in anatomic and clinical pathology at the Mount Sinai School of Medicine in New York, New York, followed by a cytopathology fellowship at the Memorial Sloan Kettering Cancer Center in 2005. In 2005 Dr Reid joined the faculty of the Medical College of Georgia in Augusta, where she served as director of cytopathology. Since moving to her current position at Emory in 2010, Dr Reid has given multiple national and international courses and talks on pancreatobiliary cytopathology at United States and Canadian Academy of Pathology (USCAP), College of American Pathologists (CAP), American Society of Cytopathology (ASC), American Society of Clinical Pathology, and European Congress of Cytology meetings. Dr Reid has authored more than 140 peer-reviewed publications and book chapters, including chapters in the WHO Classification of Tumours of the Digestive System as well as the soon-to-be published WHO International System for Reporting Pancreaticobiliary Cytopathology, for which she also serves as an expert editorial board member. Dr Reid has served on multiple USCAP, CAP, and ASC committees and serves as a section editor for the Archives of Pathology & Laboratory Medicine as well as on editorial boards of other peer-reviewed scientific journals.