The goals of the Cytopathology Section are to provide accurate, timely, sophisticated diagnoses to guide patient treatment and to support clinical protocols and research at NIH. This is accomplished through the diagnostic service as well as the application of established and newly developed ancillary/research techniques to clinical and research samples.

Cytopathology provides diagnostic evaluation of cytology specimens that direct patient management and treatment. The Section provides complete diagnostic services for various clinical protocols at the NIH Clinical Center. We specialize in the application of ancillary techniques (i.e., immunoperoxidase, flow cytometry and, most recently, molecular testing) to patient material for the confirmation of morphologic diagnoses, evaluation for protocol entry criteria and collaborative investigations. 

Due to the nature of the specimen material evaluated by our Section, often our cases require immunoperoxidase studies (12 percent). The immunosuppressed nature of our patient population at the NIH dictates that a significant proportion of our cases require special studies for pathologic organisms (12 percent). The relatively high rate of pathologic findings, combined with the diversity of types of exfoliative and fine needle aspiration (FNA) specimens, provides a broad experience in diagnostic cytopathology for residency and fellowship training.

The Section is involved in numerous clinical research studies, many of which use FNA or exfoliative samples with immunocytochemistry and/or molecular techniques to provide ancillary diagnostic information. Examples of such studies include:

• Evaluation of expression of malignant melanoma markers (MART-1 and gp100) through the utilization of antibodies in ex-vivo FNAs from malignant melanoma patients; 
• Evaluation of expression of epithelial markers (CK AE1/AE3 and CK 8/18) through the utilization of antibodies in ex-vivo FNAs from gastrointestinal carcinoma patients; 
• Evaluation of expression of epithelial markers (CK AE1/AE3 and CK 8/18) through the utilization of antibodies in ex-vivo FNAs from non-gastrointestinal carcinoma patients;
• Morphologic and immunocytochemical evaluation of tumor infiltrating lymphocytes samples for possible tumor cell contamination prior to therapy;
• FNA material for subsequent analysis by polymerase chain reaction (PCR), microarray, and other molecular technologies;
• Evaluation of cell lines by morphology and immunocytochemistry; and 
• Application of RNA-based molecular technique to non-gynecologic and FNA cytology samples to enhance diagnosis, prognosis and patient management.