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It is critical for all pathologists to maintain and expand our diagnostic skills in diseases of infancy (including placental pathology), childhood and adolescence. Many diagnostic entities in pediatric pathology are infrequent in practice, such as orphan diseases, rare tumors and complex syndromes. Underlying genomic etiologies or associated molecular alterations are discovered with increasing frequency, and their detection is driven by rapid advancement of technology. Smaller specimen size and tissue sampling at earlier stages of disease add to the diagnostic challenge. These and related factors lead to increasing complexity and difficulty in making diagnoses, with greater utilization of ancillary testing and consultation. The ability to recognize the diversity of clinical, gross, microscopic and molecular features of a disease is essential to arrive at an accurate diagnosis and to serve as medical consultants.

Needs Assessment:
To meet participants' educational needs as evident from comments on program evaluations, survey responses, and discussion on the PEDPATH list server, the Slide Survey is designed to enhance participants' knowledge and competence as relevant to the practice of pediatric pathology.

Needs for enhanced knowledge range from knowledge of the nature and etiology of specific disease entities, through diagnostic workup with incorporation of molecular or other new testing, to their prognostic relevance in clinical management. Cases selected for this activity are exemplary of entities in the spectrum of participants' educational needs. Post-test review-type discussions provide a broader context and further refine relevant knowledge.

The needs for competence in diagnostic work-up span from formulating relevant differential diagnoses on a basis of clinical history/presentation, gross exam and microscopic exam, through identifying, performing and interpreting appropriate ancillary testing, to making the correct diagnosis. This activity follows this format and fulfills a unique need especially for demonstrating competence in a range of surgical pathology and cytology specimens obtained from pediatric patients. This activity fulfills requirements for part IV of Maintenance of Certification by the American Board of Pathology. Furthermore, each mailing includes a pediatric pathology-specific cytology case that meets requirements for competency testing in laboratories that perform cytologic evaluations.

Slide Survey:
The Slide Survey Program of the SPP is intended for all pathologists and pathology trainees. It consists of 18 cases per year (3 sets of 6 cases each, including 4 glass slides, 1 biopsy virtual slide, and 1 cytology virtual slide per set). The online component (SSO) of the slide survey includes virtual microscope slides, digital versions of the booklets and the electronic answer-submission sheets, as well as survey analysis, case discussion, and case archives. Participants can expect to spend approximately one hour on each case, including reviewing the history and slide, arriving at a diagnosis, answering the questions, and reviewing the contributor's summary and case discussion. Access to the SSO is available to all subscribers. Glass slide subscription is available to all SPP members (U.S. and international), as well as non-SPP members with a mailing address in the U.S. or its territories. Glass slide subscription is not available to international participants who are not SPP members.

Program Objectives:
By reviewing the case material, formulating a differential, arriving at a diagnosis, answering the submitted questions, and reviewing the contributor's summary and post-test discussion, the participant will gain competence in diagnostic skills and understanding of the conditions submitted for evaluation. Individual evaluation is not provided and the program is not approved as or meant to be a formal proficiency program.

Technical Requirements:
Operating Systems:
PC: Windows (2000, XP, 7)
Mac: OS X 10.4 (Tiger) or later

Supported Browsers: Firefox, Chrome, Internet Explorer

To download and view documents:
PC or Mac: Adobe Reader or Acrobat (Click here to download the latest version of Adobe Reader.)

Virtual Slides: Aperio virtual slides may be viewed using the web-based viewer or Aperio ImageScope.

To use web-based viewer:
PC or Mac: Adobe Flash Player (Click here to download.)

To install ImageScope on a PC:
Operating System: Windows (2000, XP, 7)
Memory: At least 256MB
Hard Disk: Must have at least 30MB of free hard disk space
CPU Speed: 450 MHz or faster
Video Card: Must support at least 24.bit color resolution
Monitor: Resolution should be at least 1024X768

To install ImageScope on the Mac:
Operating Sytem: Mac OS X (Tiger) 10.4.6 or higher running on Intel powered Mac
Memory: At least 512 MB RAM, recommended 1 GIG Ram
Hard Disk: Must have 30 MB free hard disk space for Parallels Desktop installation, plus sufficient space allocated
for Windows XP operating system. 15 GIG of hard disk space recommended.
(Also required: Parallels Desktop License, Windows XP OS License and installation disk)

CME Credit/Certificates of Participation

Accreditation Statement
The Society for Pediatric Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement
The Society for Pediatric Pathology designates this enduring material for a maximum of 18 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

International Physicians
The American Medical Association has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™.

Health Professionals
Health Professional participants (including residents and fellows-in-training) may claim hours to receive a Certificate of Participation for an activity designed for AMA PRA Category 1 Credits™.

CME Credits
Certificates of continuing medical education AMA PRA Category 1 Credits™ will be issued through the Society for Pediatric Pathology. CME credits will only be awarded after 1) completion of an online evaluation form and 2) achieving a passing score of 80% on an online learning assessment. A maximum of 18 CME credits can be earned (6 CME credits per mailing). The actual number of CME credits earned by a participant will be based on responses meeting these requirements for each mailing. If a passing score is not achieved on the first attempt, the participant will be given the option to answer the questions repeatedly until a passing score is achieved. Participants may also opt out of CME credits. The participant will then be directed to the on-line evaluation and cumulative data from all participants.

Important CME Information about Enduring Materials

The American Medical Association (AMA) has announced a modification in the AMA Physician's Recognition Award (PRA) and credit system effective July 1, 2011. A certified CME activity that endures over a specified time is considered enduring material. Society for Pediatric Pathology (SPP) enduring materials refer to the Slide Survey Online (SSO). According to AMA, enduring materials released or renewed on or after July 1, 2011, must "provide an assessment of the learner that measures achievement of the educational purpose and/or objective(s) of the activity with an established minimum performance level..."[1]

This change means that any new educational content posted or revised on or after July 1 to the SPP Slide Survey Online, as well as future SPP-sponsored enduring materials, will require participants to take and pass the learning assessment to fulfill both the new AMA modification for obtaining AMA PRA Category 1 Credits™. Upon passing the assessment (minimum performance level is 80% correct), participants will receive AMA PRA Category 1 Credits™. If a passing score is not achieved on the first attempt, the participant will be given the option to answer the questions repeatedly until a passing score is achieved.

[1] The Physician's Recognition Award and credit system. Information for accredited providers and physicians on the 2010 revision is available by clicking here.

If you have questions regarding CME, please contact the SPP office at or 706-364-3375.

ABP - Maintenance of Certification (MOC):
The slide survey program is approved by the American Board of Pathology for Part IV (Performance in Practice) Maintenance of Certification. Therefore, diplomates of the ABP may use this program to demonstrate laboratory and/or individual participation in a laboratory / interlaboratory performance improvement and quality assurance program.

ABMS competency this activity addresses: Medical Knowledge.

Comments and Case Submissions:
Anita Sengupta MD, Slide Survey Chair
Department of Pathology, B2272
Children's Medical Center
1935 Medical District Drive
Dallas, TX 75235

Faculty Disclosure:
In accordance with the Accreditation Council for Continuing Medical Education (ACCME) Guidelines, the SPP requires that anyone in a position to influence or control the content of CME disclose any relevant financial relationship(s) which they or their spouse/partner have, or have had within the past 12 months, with a commercial interest(s) that relate to the content of this educational activity and create a conflict of interest. Any identified potential conflicts will be reviewed and resolved prior to the presentation. Relevant information will be published in the appropriate publications and/or on the SPP website.

Glossary of Terms

Commercial Interest
The ACCME defines a "commercial interest" as any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests. For more information, visit

Financial relationships
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

Relevant financial relationships
ACCME focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CME activity. ACCME has not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines "relevant financial relationships" as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.

Conflict of Interest
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.

Copyright Information:
All materials posted on this website, including online educational programs, are subject to copyrights owned by the Society for Pediatric Pathology (SPP) and other individuals or entities. Any reproduction, retransmission, or republication of all or part of any document found on this site is expressly prohibited, unless the SPP or the copyright owner of the material has granted prior written consent to reproduce, retransmit, or republish the material. All other rights reserved.

Inclusion of material in the Slide Survey does not necessarily preclude its publication in other forums; however, authors wanting to publish the same photographs or text elsewhere are here advised that alternate publishers often require transfer of the copyright to them, and would need to be informed that the material is already published on-line. We recommend that when publishing the case elsewhere, to help alleviate such concerns, authors use different photographs and text than the material provided for Slide Survey programs.

SPP Privacy and Confidentiality Policy:
Please click here to review the SPP Privacy and Confidentiality Policy.

Subscription Information:

For the 2015 Slide Survey, you may subscribe online by clicking here.

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Subscription deadline: April 1, 2015.

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