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Direct immunofluorescence (DIF) techniques provide the gold standard diagnostic tests for a number of autoimmune immunobullous diseases, including pemphigus and pemphigoid and have clinical utility in other autoantibody-mediated disorders. They are typically performed on unfixed, frozen skin, mucosal and renal biopsies. For optimal diagnostic value, material for DIF requires careful preparation and a number of factors contribute to the quality of the assessed tissue sections. In particular, weak specific fluorescence intensity and high non-specific background fluorescence can hinder accurate interpretation.

This presentation will provide a brief overview of best practice for optimising DIF performance, with a focus on skin and mucosal biopsies. Troubleshooting and helpful tips will be provided covering areas including specimen preparation and the importance of using an appropriate transport medium, rinsing considerations prior to block preparation, factors influencing embedding and cryotomy, protocols for optimising fluorescence and appropriate use of conjugates, imaging considerations for digital pathology solutions, storage of material prior to reporting and best practice strategies for maintaining internal and external quality control, with reference to the NEQAS CPT DIF EQA scheme.

An overview of how Bioinformatics has developed within Anthony Nolan, it's key projects and its impact moving forward. Areas covered will include:

A brief overview of Bioinformatics
Using Bioinformatics at Anthony Nolan;
The IPD reference Databases, in particular the IPD-IMGT/HLA Database
Population genetics of the HLA register
An insight into HLA sequencing and clinical impact
The future of bioinformatics at Anthony Nolan

Delegates will:

Gain an appreciation of the diversity and range of tumour types that can be assessed using Mohs.
Comprehend the complexity of technical requirements to ensure cases are dealt with effectively.
Recognise unusual findings and be able to adjust the investigative procedures in a 'live' setting
Appreciate tumour pattern recognition in Mohs cases

Develop an understanding of the required equipment used in a modern Mohs laboratory
Understand how to embrace design and automation in a modern Mohs laboratory.
Understand the required skills while they are using automated and advanced equipment in Mohs laboratory.
To be aware how automated and advanced equipment will provide enhanced and more accurate results and improve quality performance.

Molecular testing is now part of the standard of care pathway for many types of solid tumours with new tests being required to be introduced into laboratories quite rapidly. As part of the quality process external quality assessment (EQA) is required to ensure that the results obtained in this testing are accurate.

This talk will provide an overview of how EQAs for molecular pathology are delivered, summarise the results for some of these EQAs highlighting some of the issues observed. It will also highlight some of the different technologies used for testing and how reporting of results is assessed in the EQAs

Delegates will learn:

What Gestational trophoblastic disease is, including the different types and how they arise
How to handle a sample at the dissection bench including comparison with normal products of conception
How to distinguish between the different types of disease and mimics
What a diagnosis of gestational trophoblastic disease means for the patient
What the malignant entities of Gestational Trophoblastic Disease include

This presentation will give delegates attending an:

Overview of the pre-analytical processing pathway and potential risks associated with each stage.
Historical/current/prospective optimisation of the pre-analytical pathway.
Understanding of the near-future perspectives for standardisation-will technologies such image analysis and spatial profiling affect the practice of pathology laboratories.

Digital imaging for remote viewing to enable reporting is becoming increasingly prevalent in the NHS cellular pathology services. Sea change levels of improvement in the technology that enables digital image acquisition, viewing, transfer and storage has allowed its widespread deployment and adoption and concomitant to this has been the development of software applications to enable the analysis of those digital images for a huge variety of reasons.

In my talk I will discuss the application of digital image analysis to the scans of the slides that we assess as part of our routine external quality assessment (EQA) workload. Both as aids to improve the information and the accuracy of that information e.g., in the assessment of the proliferation marker Ki-67 in breast cancer to improve its use as a prognostic marker, and as a tool to verify and quality control our own processes and EQA materials e.g., the measurement of reproducibility and homogeneity in tissue and cell line samples used in the assessment of PD-L1 immunohistochemistry staining in non-small cell lung cancer.

This presentation will examine a specific case study submitted as part of the 'Advanced Specialist Diploma in Breast Pathology'. The case in question was a mastectomy sample for the treatment of diffuse multifocal invasive ductal carcinoma.

Within the presentation I intend to highlight the importance of pre-analysis and emphasise its correlation with macroscopic examination and block sampling. I will also highlight the importance of post analysis and the understanding of how the role of the Advanced Practitioner can directly impact patient treatment.

Delegates attending this presentation will:

Receive an overview of the clinical history of MMR/Lynch Syndrome, EQA and data from UK NEQAS ICC & ISH
Gain a better understanding of the importance of MMR testing and the UK NEQAS ICC & ISH assessment process.
The presentation will also focus on acceptable and not acceptable tests, and the importance of ideal controls.