“I had this vague idea of becoming a general practitioner, but during first year of medical school I was seduced by pathology. I just loved the aspect of detective work, which really is the essence of pathology. I loved looking at a glass slide for the clues to the diagnosis.” – Edmund S. Cibas, MD
I was a chemistry major as an undergraduate at Harvard, but I also had been playing the piano since I was eight years old. For a while I had actually considered a career as a classical pianist, but I loved the sciences, too. After doing a lot of soul-searching I realized that medicine was probably a more viable career than music so I decided to go to medical school. I was initially planning a career as a family doctor. I had this vague idea of becoming a general practitioner, but during first year of medical school I was seduced by pathology. I just loved the aspect of detective work, which really is the essence of pathology. I loved looking at a glass slide for the clues to the diagnosis. I had been a fan of detective novels when I was a kid. I used to read all the Hardy Boys mysteries. So, I think it was kind of a good fit for me, pathology being all about detective work.
Cytopathology is the aspect of anatomic pathology that deals with tissue samples obtained using minimally invasive methods. In other words, cytopathology is anything that doesn’t require a surgeon cutting out a sample with a scalpel. I look at things that can be scraped, like a Pap smear, brushed or washed like the bronchial tree, aspirated like body cavity fluid, or taken by fine needle aspiration, like a solid tumor. Given the health care environment and its financial constraints, cytopathology is an important specialty because it is relatively inexpensive. The technology that we use in cytopathology is fairly simple, and yet it’s very powerful. There’s a lot that we can accomplish diagnostically using these minimally invasive methods. The other change is that we’re living in the era of genomics now with enormous breakthroughs in understanding the causes of disease. So, it’s important for us now to leverage the cytologic specimens and apply the techniques that we’ve learned from genomics to develop better personalized medicine.
Cytology: Diagnostic Principles and Clinical Correlates, 3rd Edition is a comprehensive book of cytology that covers every aspect from exfoliative cytology to fine needle aspiration cytology. There are a lot of cytology books out there, but I think this one is unique for three reasons. First, it is comprehensive. Second, while it’s comprehensive, it’s also portable and concise. It’s about 500 pages, the text is brief, and the key points are summarized in bulleted capsule summaries, which people find extremely useful as a kind of mnemonic aid. Third, it emphasizes clinical correlation to the diagnoses that we make. Not only is the book a guide to how to make a diagnosis, but it also places everything in a clinical context. Why do we screen for cervical cancer? Why do we do fine needle aspirations of the thyroid? What are the clinical implications of the diagnoses that we make? I think if we understand better what the clinical implications are, we’re better able to make diagnoses.
Edmund S. Cibas, MD is Professor of Pathology at Harvard Medical School and director of the Division of Cytopathology in the Department of Pathology at the Brigham and Women’s Hospital in Boston, Massachusetts. His research interests include the application of cytology and cytologic methods, such as fine needle aspiration, to cancer diagnosis and treatment response. He is an author of Cytology: Diagnostic Principles and Clinical Correlates, 3rd Edition.
Dr. Cibas holds a medical degree from Harvard Medical School. He completed a residency in pathology at Brigham and Women’s Hospital and a fellowship in cytopathology at Memorial Sloan-Kettering Cancer Center. He is board-certified in anatomic pathology and cytopathology. He has been recognized for his work as an educator with an Excellence in Education Award from the American Society of Cytopathology.