A little bit about Cytotechnology: My experience in the lab.

My name is Urieliz and I am a Cytotechnologist.

Most of you might not know what a Cytotechnologist is or what we do. Well, I explain this in a previous article in AUC Frontline, here is the link: https://aucfrontline.com/2021/05/24/how-my-post-baccalaureate-degree-helped-me-identify-with-a-specialty-during-medical-school/.

I encourage you to click on it and let me enlighten you in this matter. 🙂

So, how did I become a Cytotechnologist?

After my undergrad, I obtained a Post-Baccalaureate Certification in Cytotechnology from the University of Puerto Rico-Medical Sciences Campus and, after taking all my exams and board, I got Licensed by the American Society of Cytopathology (ASCP).

In the lab that I worked at, the main samples that we screened were Pap Smears. A Pap Smear is a screening test invented by George Papanicolaou that tests for precancerous and cancerous lesions in the cervix. It is one of the most successful screening tests ever invented preventing great amounts of women from developing cervical cancer. The Pap test is not a diagnostic test, it is a screening test. Therefore, it is important not to forget to get your Pap test done.

In the laboratory, we used ‘The Bethesda System for Reporting Cervical Cytology’*. Some of the parts of this diagnosing system included the following:

  • Identifying the adequacy of samples: I would identify the slides as ‘Satisfactory for evaluation’ or ‘Not satisfactory for evaluation’. I would also identify a reason why the samples are not satisfactory, such as: Inflammation, bloody smear, absence of cells, etc.
  • The next step would be identifying any infection such as Candida Albicans, Trichomonas, Herpes, among others.
  • Then I would identify any reparative changes or reactive processes in the cells and the cause of them, such as: inflammation, IUD, radiation therapy, among others.
  • Finally, I would diagnose any neoplastic lesion, from Atypical Squamous Cells of Undetermined Significance (ASCUS) or Atypical Glandular Cells of Undetermined Significance to a malignant lesion (including squamous tissue, glandular tissue, or metastasis.).

*In this article I only include a limited summary of this system, I will include a complete paper about ‘The Bethesda System for Reporting Cervical Cytology’ in my references for those interested in learning more.

Other samples that I have screened are:

  • Thyroid
  • Lungs
  • CSF
  • Anal
  • GI
  • Other tumors

Some of the other experiences that I had as a Cytotechnologist include:

  1. Assisting a Pathology during Fine Needle Aspiration of the Thyroid and Lungs
  2. Processing of samples (Gynecological and Non-gynecological)
  3. Statistics for the different diagnoses
  4. Going to the operating room during surgery to obtain a sample

Besides the clinical aspect of the field, I was also very involved in the literature aspect of it. Thus, I worked on and presented many study cases in different conferences:

My first case was a Metastatic Renal Cell Carcinoma in Pancreas presented in the American Society of Cytotechnology (ASCT) Annual Meeting in Salt Lake City, Utah in 2018.  In 2019, I was the first Cytotechnologist to present a case at the Academy of Pathology and Molecular Medicine Annual Meeting in San Juan, Puerto Rico. I presented the case: “Medulloblastoma. Initial Approach by Cytology”. This same year I presented the case: “Pediatric Oligodendroglioma: A case report and literature review.” In the 9th Annual Puerto Rico Oncology Symposium.

Here are some of my favorite Pap Smear pictures from my days I the lab:

Pap smear #1: Negative for intraepithelial lesion or malignancy (NILM). Candida albicans.
Pap smear #2: NILM. Pap Stain. (40x)
Pap smear #3: Low-grade Squamous Intraepithelial Lesion (LSIL). Pap Stain. (40x)

With this article I hope to shed light on the importance of Cytotechnologists, early diagnosis, and the Pap test. There is so much more about Cytotechnologists that I would love to write about overwhelm you if I kept writing about it in this article. So, I hope to see you in the next one or next time I will be writing about how it feels to finally become a Pathologist!

Sources:

Nayar R, Wilbur D, C: The Bethesda System for Reporting Cervical Cytology: A Historical Perspective. Acta Cytologica 2017;61:359-372. doi: 10.1159/000477556. Retrieved June 20, 2021 from https://pubmed.ncbi.nlm.nih.gov/28693017/

Cytotechnology – Escuela de Profesiones de la Salud. (n.d.). Retrieved June 18, 2021, from https://eps.rcm.upr.edu/cythotechnology/

Smith, R. (n.d.). Study. Retrieved June 19, 2021, from https://cytologystuff.com/study/gyn-atlas-table-of-contents/atypical-squamous-cells/

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