The first are medically qualified cytopathologists who examine tissues and fluids at the cellular level with a microscope to analyse and help advise on treatment. Cytological investigations include the examination of surface impression preparations, the examination of preparations made from liquids such as sputum, fluid from cystic lesions, cerebrospinal fluid and fine needle aspiration (FNA) cytology of solid lesions.
Fine needle aspiration (FNA) is a very important technique used as a rapid method to determine if a solid lump of tissue is benign or malignant. By extracting some cells from the lump using a syringe and needle, and then examining these under a microscope, an experienced cytopathologist can look for the presence of abnormalities and make a diagnosis. The use of a fine needle is less painful for the patient and less invasive than a biopsy and it is possible in many instances for a diagnosis to be made in the clinic so that appropriate treatment can be planned at the time, speeding up the treatment that the patient receives.
This is an especially useful technique in diagnosing the status of breast lumps as part of the National Breast Screening service.
The second group are cytology screeners who are best known for their role within the NHS National Cervical Screening Programme detecting pre-malignant changes within the cells taken from the cervix (neck of the womb) on stained slides. Cervical screening saves over 1,000 lives in the UK each year and has drastically cut the rates of invasive cancer.
The third group is biomedical scientists who carry out all of the same roles as cytology screeners and some of the roles of Cytopathologists. Recently the role of advanced practitioner has been developed, where suitably experienced and qualified biomedical scientists take a diagnostic role similar to that of the Cytopathologist and are involved in the clinical management team for groups of patients.
Cytology is frequently believed to be a pathology discipline of the 20th and 21st century but it has origins going back to more than three centuries ago when the English scientist Robert Hooke made the first observations of cells in 1665.
As well as histology, cytology forms the pathology discipline of cellular pathology. Cytology is by definition the medical and scientific study of cells. Cytology relates to a branch of pathology, the medical specialty that deals with making diagnoses of diseases and conditions through the study of tissue samples from the body.
Cytologic inspections may be performed on body fluids (examples are blood, urine, and cerebrospinal fluid) or on material that is aspirated (drawn out via suction into a syringe) from the body. Cytology also can involve examinations of preparations that are scraped or washed (irrigated with a sterile solution) from particular areas of the body. For example, a frequent example of diagnostic cytology is the evaluation of cervical smears (referred to as the Papanicolaou test or Pap smear).
In order for cytologic evaluation to be carried out, the material to be examined is spread onto glass slides and stained. A pathologist then uses a microscope to examine the individual cells in the sample.