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CytoJournal- Open Access & CMAS on EUS FNA of Pancreas

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This presentation discusses about Open Access Publishing and evolution of CMAS on EUS FNA of pancreatic lesions. A few case studies are also discussed.

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CytoJournal- Open Access & CMAS on EUS FNA of Pancreas

  1. 1. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Publishing in "OPEN ACCESS" A preview of  CytoJournal monograph on  EUS-FNA of pancreatic lesions July 8, 2009 Vinod B. Shidham, MD, FRCPath, FIAC Professor Co-editor-in-chief & Executive editor, CytoJournal (www.cytojournal.com) Dept of Pathology, Medical College of Wisconsin 9200 W Wisconsin Av, Milwaukee, WI vshidham@mcw.edu
  2. 2. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Outline Introduction to Open Access Publishing Impact monitoring matrices Long term sustenance Evolution of CMAS [CytoJournal Monographs & Atlas Series] EUS-FNA of pancreatic lesions General Case studies
  3. 3. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open-access (OA) literature is digital, online, free of charge, and free of most copyright and licensing restrictions. Everything published in ‘Open Access’ is freely available online for all to read, download, copy, distribute, and use any manner after attributing due credit to original material. Shorthand definition by PLoS (Public Library of Sciences) Free availability and unrestricted use Peter Suber. Open Access Overview. http://www.earlham.edu/~peters/fos/overview.htm
  4. 4. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Budapest Open Access Initiative “Free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited." http://www.soros.org/openaccess/read.shtml
  5. 5. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu What do we mean by Open Access? Open Access articles are: q Universally accessible via the Internet, without subscription barriers q Licensed so as to allow download, redistribution and reuse, in whole or in part, as long as attribution is retained q Permanently archived in an internationally recognized repository (e.g. PubMed Central)
  6. 6. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu In brief OA publication extends two most important components- ►Readers can freely access ► Authors do not loose copyright
  7. 7. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu OA is compatible with copyright, peer review, revenue (even profit), print, preservation, prestige, career- advancement, indexing, and other features. It is supportive for the services associated with conventional scholarly literature.
  8. 8. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu The resultant benefits are huge with service to many groups including- Authors, Readers, Teachers & students, Libraries, Universities, Journals and publishers, Funding agencies, Governments, general public (Citizens), and so on----
  9. 9. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu We will focus on benefits For Authors: ► Extends worldwide audience (larger than that of any subscription- based journal, no matter how prestigious or popular) ► Verifiable http://opcit.eprints.org/oacitation-biblio.html  increase in visibility and impact of their work. For Readers: ► Allows barrier-free access to the literature crucial for their research (without fiduciary constrains). ► Enhanced convenience, reach, and retrieval power. ► Many other benefits related to the web-based technologies such as full-text searching, indexing, mining, summarizing, translating, querying, linking, recommending, alerting, "mash-ups" and other forms of processing and analysis.
  10. 10. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu a. Traditional method of publishing due to lack of alternative Restricted $ access, thus Loose your limiting copyright TICKETS dissemination and visibility of our Author Peer reviewer Your manuscript work ©vshidham b. . Now alternative opportunity to publish in open access is a reality Unlimited dissemination and Retain your visibility Author copyright resulting in Peer reviewer enhanced citation Your manuscript of our work ©vshidham Shidham VB, Sandweiss L, Atkinson BF. First CytoJournal Peer-Reviewer's Retreat in 2006 - Open access, peer-review, and impact factor. Cytojournal. 2006 Mar 27;3(1):5 doi:10.1186/1742-6413-3-5 Free full text available at: http://www.cytojournal.com/content/3/1/5
  11. 11. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu To this day OA publishing in biological sciences and other areas is relatively well established with evolution of models compatible with long term sustainability. Many institutions and top universalities including- NIH/NCI Harward NHS (UK) Many more are taking steps to harvest the power of OA publishing.
  12. 12. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu ------- Stuart M. Shieber, a professor of computer science at Harvard who proposed the new policy, said after the vote in a news release that the decision “should be a very powerful message to the academic community that we want and should have more control over how our work is used and disseminated.”
  13. 13. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Many publishers adopting open access Have emerged- PLoS (USA) MedKnow (India) BioMed Central (UK)
  14. 14. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Impact matrices
  15. 15. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Although conventionally Impact Factor (IF) has been available and widely popular approach to measure the quality of publication- IF has many drawbacks and does not reflect individual publication and author(s). IF is not available freely- and has to be dependent on info extended by the journal or buy ‘Journal Citation Report’ from commercial resource- Thomson Reuters As well known best work may published in relatively less prestigious journal but may have higher impact and vice versa. Shidham VB, Pitman MB, DeMay RM, Atkinson BF. CytoJournal’s move to the new platform: More on financial model to the support open-access charter in cytopathology, publication quality indicators, and other issues CytoJournal 2008, 5:15 (16 December 2008) Free full text available at: http://cytojournal.com/temp/CytoJournal5115-5043123_140031.pdf
  16. 16. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open access journals in Cytopathology Out of five international Cytopathology Journals CytoJournal (projected IF for 2008- 1.06) Acta Cytologoica (IF 2002- 0.937), Cytopatjhology (IF 2002- 1.144), Cancer Cytopathology (IF 2002- 1.660), and Diagnostic Cytopathology (IF 2002- 0.991) currently CytoJournal www.cytojournal.com is the only Open Access cytopathology journal. IFs for 2002 obtained from- http://www.genebee.msu.su/journals/if02a.html
  17. 17. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  18. 18. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD,As of Jan 18, 2008 FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu About SJR (SCImago Journal Rank Indicator) http://www.scimagojr.com/aboutus.php
  19. 19. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Comparison of SJR As of Jan 18, 2008 Comparison of SJRs for CytoJournal with other PubMed indexed cytopathology journals. Cancer Cytopathology- was not comparable by SJR (as it is not independent Cytopathology journal, it is section of ‘Cancer’ journal without its independent Source- http://www.scimagojr.com/compare.php? ISSN number). j1=CytoJournal&j2=Cytopathology&j3=Diagnostic+Cytopathology&j4=Acta+Cytologica&un=journals&inj=0 CytoJournal, Cytopathology, Acta Cytologica, Diagnostic Cytopathology * * * * * * * * * * * * * CytoJournal was ** launched in * August 2004.
  20. 20. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  21. 21. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  22. 22. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu In the pre-internet era there was no simple alternative. However, with the advent of internet, which made ‘Open Access’ publishing a reality, has also extended numerous, real time, freely available tools with more versatility. These tools have been tremendously enhanced by numerous and continuous refinements by ‘Google Scholar’ (http://scholar.google.com/). There are many possibilities based on Google scholar and one of the simplest is ‘Publish or Perish’ from Harzing.com Shidham VB, Pitman MB, DeMay RM, Atkinson BF. CytoJournal’s move to the new platform: More on financial model to the support open-access charter in cytopathology, publication quality indicators, and other issues CytoJournal 2008, 5:15 (16 December 2008) Free full text available at: http://cytojournal.com/temp/CytoJournal5115-5043123_140031.pdf
  23. 23. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu http://scholar.google.com/
  24. 24. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Free download of ‘Publish or perish’ software is available from- http://www.harzing.com/resources.htm Citation metrics analyzed by Publish or perish http://www.harzing.com/pop.htm
  25. 25. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  26. 26. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  27. 27. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  28. 28. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  29. 29. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Citation metrics analysis- XXXXXX http://www.harzing.com/pop.htm XXXXXX
  30. 30. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Long term sustenance Probono services Philanthropy Grants/funding Rewards Various financial models
  31. 31. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu CytoJournal’s business model (Owned by Cytopathology Foundation Inc & published by MedKnow Pvt Ltd ) q CytoJournal does not charge subscriptions q But, like all journals, it does incur costs q Article Publication charge (APC) covers infrastructure for: Editorial activities: peer review activities, EB meetings, handouts, etc Technical: Development, maintenance and hosting of online journal system Production: Formatting and markup of articles, indexing services Customer service for authors/readers q Web technology allows lower cost
  32. 32. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open access publication charges q CytoJournal has continued flat APC of $1500 q CytoJournal’s APC (~$1500) are towards the lower end
  33. 33. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu q For comparison, traditional publishers often charge $3000 or more, in addition to subscription charges From- The roads to open access and BioMed Central’s business model Matthew Cockerill Publisher BioMed Central BioMed Central Colloquium Thursday 8th February 2007, The Royal College of Physicians, London, UK
  34. 34. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu CF Member, OA Stewards, OA Stewards- Plus Open access publishing does not necessarily mean ‘author-pays’ Waiver of Article Publication Charge q Vast majority of CytoJournal authors do not have to pay. q CytoJournal authors and readers could get benefits using “central fund for open access publishing” managed and supported by funding through Cytopathology Foundation Inc q Individuals, Institutions, departments, societies, organization prepay nominal charge on behalf of their authors via different schemes- Cytopathology Foundation (CF) membership http://www.cytojournal.com/CFMember.asp CytoJournal (CJ) OA Stewards, CJ OA Stewards- Plus http://www.cytojournal.com/OASteward.asp
  35. 35. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu CytoJournal promise Special waiver to any author for deserving  manuscript  based on economic hardship with grants from Cytopathology Foundation
  36. 36. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu http://www.cytojournal.com/eb.pdf
  37. 37. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open access publishing and beyond Online study cases with virtual slides (trainee corner), Online CME and conferencing, Twittering, etc
  38. 38. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open access publishing and beyond (contd) On-line line translation through Google
  39. 39. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  40. 40. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open access publishing and beyond (contd) CytoJournal Monograph/Atlas Series (CMAS)
  41. 41. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Open access publishing and beyond
  42. 42. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu http://www.cytojournal.com/monographs.asp
  43. 43. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu http://www.cytojournal.com/monographs.asp
  44. 44. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Monograph Editor- Vinod B. Shidham Contributors- Douglas Evans Kulwinder Dua Martha B. Pitman Nirag Jhala Fan Lin Academic editors  (Steering & finalizing Peer review)- Martha B. Pitman Gregg Staerkel CMAS co-editors-in-chief: David C. Wilbur, MD (Harvard Medical School / Mass Gen Hosp) R. Marshal Austin, MD, PhD (University of Pittsburgh Medical Center) Ruth Katz, MD (MD Anderson Cancer Center)
  45. 45. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  46. 46. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu EUS-FNA of pancreatic lesions
  47. 47. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Postoperative Adjuvant Therapy Author No. Patients Med. Survival P-Valve GITSG (1985) 21 20 .03 Surgery alone 22 11 EORTC (1999/2007) 60 16 .099/.165 Surgery alone 54 12 ESPAC-1 (2001) 146 20.1 .011 No chemo 139 15.7 RTOG (2008) Gem 187 21 .05 5-FU 201 17 CONKO (2008 ASCO) 179 23 .005 Surgery alone 175 20 ACOSOG (2008 ASCO) 89 27
  48. 48. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Evans DB et al. J Clin Oncol 26:3496-3502
  49. 49. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Evans DB et al. J Clin Oncol 26:3496-3502
  50. 50. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu These recent advances with pre-operative adjunct chemo-radiation for pancreatic ductal adenocarcinoma- definitive preoperative tissue diagnosis is pivotal. EUS-FNA is minimally invasive, economical, sensitive, and specific approach for retrieving diagnostic tissue material.
  51. 51. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Raut CP et al. J GASTROINTEST SURG 2003;7:118–128.
  52. 52. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Comparison of EUS-FNA and Final Diagnoses EUS-FNA Result No. of Patients Final Malignant Inconclusive No Malignant Diagnosis Cells Identified for Malignancy Cells Identified Total (%) Carcinoma 197 10 9 216 (93) Benign 0 (FP) 1 14 15 (6) Lost to follow- 0 1 1 2 (1) up Total (%) 197 (85) 12 (5) 24 (10) 233 Raut et al, J Gastro Surg 2003;7:118.
  53. 53. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pivotal role of EUS-FNA in management of Pancreatic lesions is increasing
  54. 54. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Linear Radial
  55. 55. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Tumor Pancreas Needle Duodenal wall Linear transducer
  56. 56. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu GI mucosal contamination
  57. 57. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Compare GI mucosal contamination with low grade and high-grade pancreatobilliary carcinomas (Pap stained direct smears). a. The cohesive sheets of cells in honey-comb a b configuration with bland nuclei of relatively same sizes in GI mucosal lining epithelium may superficially resemble in some areas with well to moderately differentiated ductal carcinoma (b & c) and moderate to poorly c d differentiated carcinoma (d).
  58. 58. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Lesion aspirate V a. All steps performed correctly- Good sampling V b. Valve not close at last stage- Sample lost- partially or completely by capillary action GI mucin Lesion aspirate V c. Not equalized with ambient pressure- Partially diluted sampling GI mucin Lesion aspirate GI mucin V d. Not equalized with ambient pressure, initial stages valve not closed- GI mucin V e. Improper steps at multiple stages- Inadequate sample
  59. 59. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Shidham V, Kampalath B, England J. Routine air drying of all the ------. Acta Cytologica 2001;45:60-68. Live cells Cells in smear (surface view) Cells in smear (side view) Wet-fixed smear Air-dried smear
  60. 60. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu 100X 040X 020X 002X Gross WF ADS d b a c Wet fixed smear Shidham V, Kampalath B, England J. Routine air drying of all the ------. (Pap stained) Acta Cytologica 2001;45:60-68. e WF p o n m rehydration and post-fixed in 95% ethanol with 5% Air-dried smear (Pap stained after acetic acid) q ADS
  61. 61. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu EUS-FNA of solid pancreatic lesions. EUS-FNA of cystic pancreatic lesions.
  62. 62. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  63. 63. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Triaging pancreatic EUS-FNA aspirates.
  64. 64. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  65. 65. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  66. 66. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu EUS-FNA of Pancreatic lesions Study cases
  67. 67. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Male, 51-year Intermittent right upper quadrant pain & decreased appetite- 4m Pain was transient, non-debilitating, and vague, and unrelated to oral intake or bowel movements Also had worsening post-prandial bloating without nausea or vomiting. Lost 16 pounds over the past month due to food aversion. Consumed 1-2 alcoholic drinks per day No history of GI tract or pancreaticobiliary disease. Intermittent episodes of transient, but severe, epigastric abdominal pain had been experienced in the past, but he did not seek medical attention.
  68. 68. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu CT scan
  69. 69. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu a b Ultrasound image of the pancreatic cystic lesion. a, EUS showed a 6.9 X 2.4 cm cyst (arrow) in the pancreatic body-tail region without septae or solid component. b, Under higher magnification, there is subtle layering of debris (arrow) within the cyst .
  70. 70. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Although based on international consensus guidelines (Tanaka 2006) this lesion would have been resected, FNA was performed using a 22-gauge Echotip needle. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Tanaka M et al. Pancreatology 2006; 6:17-32
  71. 71. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Only a few drops of thick, viscous, clear, mucoid fluid could be aspirated. CEA level could not be determined due to insufficient specimen quantity. The cyst did not collapse following FNA. Concern was Mucinous cystic lesion with malignancy Direct smears- insufficient for interpretation. LBC preparations were also hypocellular and initially interpreted at screening as insufficient.
  72. 72. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu EUS-FNA cytology. (Pap stained SurePath prep). Although hypocellular, there were many debris with Detached ciliary tufts  (red arrow)
  73. 73. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu a b c Rare nucleated cell groups were detectable.  Cilia (red arrows) could be detected in some. Note terminal bars (blue arrows) in some isolated ciliated cells. (Papanicolaou stained SurePath preparation).
  74. 74. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Although initially interpreted at screening as insufficient-
  75. 75. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Isolated intact ciliated columnar cells with nuclei (a through c) were rare. Detached ciliary tufts (DCT) of top fragments of ciliated columnar cells without nuclei. (d through o) were relatively many. Note  terminal  bars  (red arrowheads) in some. (Papanicolaou stained SurePath preparation).
  76. 76. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Negative for malignancy. Ciliated foregut cyst.
  77. 77. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Based on symptoms of abdominal pain, food aversion, and weight loss, the patient was referred for surgical resection of this lesion. The distal pancreatectomy achieved good palliation of his symptoms.
  78. 78. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Resection of pancreatic lesion
  79. 79. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Ciliated foregut cyst (contd) They may be misinterpreted as pancreatic cystic mucinous lesion and lead to inappropriate surgical intervention, which may be avoided with proper detection and interpretation of DCT. A case describing retrospective EUS-FNA findings after postoperative diagnosis of the surgical resection specimen has been reported. However, this is the first case of pancreatic ciliated foregut cyst, diagnosed preoperatively by EUS-FNA, to be reported in the English literature. Dua, Vijayapal, Kengis, Shidham. CytoJournal (Under review)
  80. 80. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu EUS-FNA of solid pancreatic lesions
  81. 81. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pancreatic ductal adenocarcinoma- Mod to poorly differentiated (Pap stain- Direct Smear-RH)
  82. 82. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pancreatic ductal adenocarcinoma- Mod to poorly differentiated (Pap stain- Direct Smear-RH)
  83. 83. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pancreatic ductal adenocarcinoma- Mod to poorly differentiated (Diff-Quik stain- Direct Smear)
  84. 84. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pancreatic ductal adenocarcinoma- Mod to poorly differentiated (Diff-Quik stain- Direct Smear)
  85. 85. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Male, 58-year Mass in head of pancreas. CA 19.9- within normal limits. No previous history of cancer.
  86. 86. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Acinar cell carcinoma(Pap stain- Direct Smear-RH)
  87. 87. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Acinar cell carcinoma(Pap stain- Direct Smear-RH)
  88. 88. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Acinar cell carcinoma(Pap stain- Direct Smear-RH)
  89. 89. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Acinar cell carcinoma(Diff-Quik stain- Direct Smear)
  90. 90. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Poorly differentiated carcinoma- DD- Acinar cell carcinoma Neuroendocrine carcinoma Lymphoma Poorly differentiated adenocarcinoma- NOS
  91. 91. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Positive for malignancy. Poorly differentiated adenocarcinoma- favor Acinar cell carcinoma
  92. 92. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  93. 93. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Female, 71-year Abdominal mass- head of pancreas – duodenal wall. NF-1 Benign neurofibroma vs other tumor
  94. 94. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Neuroendocrine neoplasm (Papp stain- Direct Smear-RH)
  95. 95. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Neuroendocrine neoplasm (Diff-Quik stain- Direct Smear)
  96. 96. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Neuroendocrine neoplasm (Diff-Quik stain- Direct Smear)
  97. 97. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Well differentiated neuro-endocrine neoplasm
  98. 98. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  99. 99. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Leading to appropriate management
  100. 100. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Peer-reviewed, open access, teaching material with many pictures. Hard copy and online availability. Opportunity for frequent updates
  101. 101. Cytopathology Cytopathology Open Access Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  EUS-FNA of pancreatic lesions. vshidham@mcw.edu The end Professor, Medical College of Wisconsin Milwaukee Art Museum vshidham@mcw.edu
  102. 102. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  103. 103. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Ciliated foregut cyst MCN IPMN Acinic cell carcinoma Neuroendocrine neoplasm Pancreatic ductal carcinoma Metastatic endometrial adenocarcinoma Metastatic leiomyosarcoma
  104. 104. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Metastatic adenocarcinoma- C/W endometrial primary (Pap stain- Direct Smear-RH)
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  106. 106. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Cytokeratin 7 ER CA 19.9 Cytokeratin 20 Metastatic adenocarcinoma- C/W endometrial primary
  107. 107. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  108. 108. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pancreatic ductal adenocarcinoma- with squamoid differentiation
  109. 109. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Pancreatic ductal adenocarcinoma- with squamoid differentiation (surgical specimen)
  110. 110. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu
  111. 111. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Metastatic leiomyosarcoma (Pap stain- Direct smear)
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  113. 113. Cytopathology Open Access Publishing in "OPEN ACCESS" Vinod B. Shidham, MD, FRCPath, FIAC A preview of CytoJournal monograph on  Professor, Medical College of Wisconsin EUS-FNA of pancreatic lesions. vshidham@mcw.edu Metastatic leiomyosarcoma (Cell block- HE stain) Compare with surgical specimen Metastatic leiomyosarcoma- Lung (HE stain)
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