Cytopathology Fellowship

The Department of Pathology and Laboratory Medicine at the East Carolina University School of Medicine offers a one-year fellowship in cytopathology, under the direction of Nancy L. Smith, M.D.  The fellowship provides extensive training in GYN and non-GYN cytology, including fine needle aspiration biopsy. The cytology service manages approximately 14,000 cases per year, of which greater than 800 are fine needle aspiration biopsies from multiple sites including deep thoracic and abdominal organs, breast, thyroid, lymph nodes, soft tissue, salivary glands, prostate and brain. Experience in interpreting both traditional Papanicolaou stained and Wright-Giemsa (Diff-Quik) stained smears is emphasized.

The majority of the superficial biopsies are performed by pathologists. The cytopathology fellow assists and performs these FNA biopsies in the School of Medicine clinics, hospital, and on patients referred directly to the Pathology Department. The fellow will also review all consultation cases. Contemporary techniques of performing the fine-needle aspiration biopsies are utilized, including interpretation of rapid stains such as the Diff-Quik stain for preliminary diagnosis. Often the Diff-Quik stain is used to identify either difficult and/or interesting cases that may need ancillary studies on the cytologic material. The cytopathology fellow is actively involved in obtaining specimens for immunocytochemistry electron microscopy, image analysis, and flow cytometry and will interpret these findings. An outstanding feature of the FNA biopsy service is the close cooperation and working relationship with clinical colleagues from radiology, internal medicine, surgery, obstetrics/gynecology, pediatrics and radiation oncology.

The fellow also has the opportunity to develop a strong foundation in exfoliative cytology. The training stresses both preparatory techniques and interpretation. Emphasis is placed on cytologic-histologic correlation. Opportunities are also abundant for participation in a number of ongoing conferences, including: (1) a weekly surgical pathology/cytology conference; (2) a weekly multidisciplinary oncology conference; (3) weekly pathology seminars and (4) a weekly microscopic cytology conference.

The cytology division maintains an extensive surgical pathology and cytology library, Kodachrome sets and archival study slides. Opportunity exists for teaching and collaborative research efforts in cytology. The cytology division has a strong commitment to research and is actively involved in teaching at the national level. The fellowship also provides experience in laboratory computer systems and develops a foundation for laboratory management.