Cytology (Salem Health: Cancer)
Subspecialties: Molecular diagnostics, immunocytochemistry
Cancers diagnosed: Primarily cancers of the cervix, uterus, lungs, breast, and urinary tract
Training and certification: Cytotechnologists must obtain a baccalaureate degree from an accredited college or university. This includes a twelve-month cytotechnology program accredited by the American Medical Association’s Commission on Accreditation of Allied Health Education Programs (CAAHEP).
Students must take classes in biology, chemistry, mathematics, and statistics and must meet general education requirements. Their clinical training may be in a hospital or university. Students learn how to collect and prepare samples for examination, how to use a microscope, how to recognize normal cells, and how to recognize changes in the cells that indicate the presence of disease.
After completing course work, students take the American Society for Clinical Pathology (ASCP) Board of Registry (BOR) national certification exam for cytotechnology. If they pass the exam, students receive a certificate and can use the initials CT (ASCP) after their name. Some states require state licensure of cytologists. These states are California, Florida, Hawaii, Louisiana, Montana, New York, Rhode Island, Tennessee, and West Virginia. Georgia and Nevada require state certification.
Once certified, cytotechnologists must maintain...
(The entire section is 1174 words.)
For Further Information (Salem Health: Cancer)
Abeloff, Martin D., et al. Clinical Oncology. 3d ed. Philadelphia: Churchill Livingstone/Elsevier, 2004.
American Medical Association. Health Professions Career and Educational Directory 2007-2008. 35th ed. Chicago: AMA Press, 2007.
Cibus, Edmund S., and Barbara S. Ducatman. Cytology: Diagnostic Principles and Clinical Correlates. 2d ed. Philadelphia: Saunders, 2003.
Keebler, Catherine M., and Theresa M. Somrak. The Manual of Cytotechnology. 7th ed. Chicago: ASCP Press, 1997.
Koss, Leonard G., and Myron R. Melamed. Koss’ Diagnostic Cytology and Its Histopathologic Bases. 5th ed. Philadelphia: Lippincott/Williams and Wilkins, 2006.
Rushing, Lynda, and Nancy Joste. Abnormal Pap Smears: What Every Woman Needs to Know. Amherst, N.Y.: Prometheus Books, 2001.
Swanson, Barbara M. Careers in Health Care. New York: McGraw Hill Professional, 2005.
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Organizations and Professional Societies (Salem Health: Cancer)
American Society for Clinical Pathology. http://www.ascp.org, 33 West Monroe, Suite 1600, Chicago, IL 60603.
American Society for Cytotechnology. http://www.asct.com, 1500 Sunday Drive, Suite 102, Raleigh, NC 27607
American Society of Cytopathology. http://www.cytopathology.org, 400 West 9th Street, Suite 201, Wilmington, DE 19801
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Science and Profession (Magill’s Medical Guide, Sixth Edition)
Cytology is the study of the appearance of cells, the fundamental units that make up all living organisms. Cells are complex structures constructed from many different subcomponents that must work together in a precisely regulated fashion. Each cell must also cooperate with neighboring cells within the organism. A cell is like a complex automobile: Many separate components must be synchronized, and the cell (or car) must follow a strict order of function to coordinate successfully with its neighbors. Because illness results from the malfunction of cells, physicians must be able to measure key cell functions accurately. The normal and abnormal function of cells can be evaluated in many different ways; cytology is the study of cells using microscopes. A sophisticated collection of cytological techniques is available to pathologists; with these a precise diagnosis of cellular malfunction is possible.
All cells share several basic features. They are surrounded by a membrane, a flexible, sheetlike structure which encloses the fluid contents of the cell but allows required materials to move into the cell and waste products to move out of it. The complex salty fluid contained by the membrane is the cytoplasm; the other subcomponents of the cell, called organelles, are suspended in this substance. Each cell contains a set of genes, located on chromosomes, which function as blueprints for all other structures of the cell; the...
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Diagnostic and Treatment Techniques (Magill’s Medical Guide, Sixth Edition)
Before cells can be successfully observed, they must be prepared through several steps. First, it is necessary to select a relatively small sample of a particular organ for closer scrutiny. Such a sample is called a biopsy when it is collected by a physician who wishes to test for a disease. The biopsy must then be preserved, or fixed, so that its parts will not deteriorate. Next, the specimen must be encased within a solid substance so that it can be handled without damage. Most often, the fixed specimen is soaked in melted paraffin, which then is allowed to solidify in a mold. For some kinds of microscopes, harder plastic materials are used. Next, the specimen must be thinly sliced so that the internal details can be seen. The delicate slices are mounted on a support, typically a thin glass slide for light microscopy. Finally, the parts of the cell must be colored, or stained. Without this coloring, the cell parts would be transparent and thus unobservable.
The basic tool of the cytologist is the light microscope. It can magnify up to about seven hundred times. Numerous sophisticated methods are used with light microscopy. Specific stains have been developed for distinguishing the different molecules that make up cells. For example, Alcian blue is a dye that stains a type of complex sugar that accumulates outside certain abnormal cells, making it easier to identify these cells. Also, specially prepared...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
Of the diagnostic procedures that are available to physicians, cytologic techniques are among the most popular. Because the cells being examined are so tiny, the microscopes used must be able to magnify the cells enough to allow observation of their characteristics. Historically, the use of cytology in medical practice has closely paralleled the development of adequate microscopes and methods for preparing specimens.
Magnifying lenses by themselves lack the power required for observing cells. A microscope of adequate power must use several such lenses stacked together. The first crude microscopes with this design appeared late in the sixteenth century. During the next several hundred years, microscopes were mostly used to observe cells of plant material because the woody parts of plants can be thinly sliced and then observed directly, without the need for further preparation. The word “cell” was first employed by Robert Hooke (1635-1703) in a paper published in 1665. He observed small chambers in pieces of cork, which were where cells had been located in the living cork tree. These chambers reminded Hooke of monks’ cells in a monastery, hence the name.
The great anatomist Marcello Malpighi (1628-1694) may have been the first to observe mammalian cells, within capillaries. The real giant of this era, however, was the Dutch microscopist Antoni van Leeuwenhoek (1632-1723), who greatly improved the quality...
(The entire section is 493 words.)
For Further Information: (Magill’s Medical Guide, Sixth Edition)
Kumar, Vinay, et al., eds. Robbins Basic Pathology. 8th ed. Philadelphia: Saunders/Elsevier, 2007. Presents a reasonably concise overview of the entire field of pathology, but the emphasis is on cytology. The chapter on disease at the cellular level is excellent and readable. The authors are unusually adept at explaining the facts in a simple and interesting way.
Taylor, Ron. Through the Microscope. Vol. 22 in The World of Science. New York: Facts On File, 1986. A fine introduction to the wonders of microscopy, recommended for all readers. In a large format with more than one hundred beautiful photographs. The clear, simple, and brief text explains how microscopes work and what is being seen. The section “Microscopes, Health, and Disease” is particularly relevant, explaining cytological detective work.
Wolfe, Stephen L. Cell Ultrastructure. Belmont, Calif.: Wadsworth, 1985. This book presents electron microscope photographs of the important structures of viruses, bacteria, and plant and animal cells. Included for most structures are three-dimensional drawings that are particularly useful for visualizing how cells are put together.
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Cytology (Encyclopedia of Cancer)
Cytology is the examination of individual cells and small clusters of cells, and may be used for the diagnosis and screening of diseases, including cancers. Cytology can also be referred to as cytopathology.
Diagnostic tests are used to detect a disease in individuals who have signs, symptoms, or some other abnormality that is indicative of disease. A screening test identifies those who might have a certain disease, sometimes before they develop any symptoms, but does not absolutely prove that disease is present. If a screening test is positive, a diagnostic test can be used as follow-up to verify the diagnosis.
Procedures to gather cells for cytology are often less invasive than other forms of biopsy, and therefore may
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