My Cytology Journey Final€¦ · Dr. Asma Tarazi • Isttrained ... Histo Cyto CytoRatio: 29% KHCC...
Transcript of My Cytology Journey Final€¦ · Dr. Asma Tarazi • Isttrained ... Histo Cyto CytoRatio: 29% KHCC...
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Successes and Shortfalls of the Cytopathology Service
In the Middle‐East Region
Nael M. Soudi, MS, CT(ASCP)(MIAC),CPHQ, LSSGB.Chief Quality Officer
MedLabs Consultancy GroupAmman‐Jordan
My Cytology Journey:
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Saving The Best For Last
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Outline
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Recognition
What Did Not Work
My CytologyJourney What Worked
Open ForumThe World of Cytology
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Cytology In The Middle East
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Timeline In The Middle East
IranJHH @ Tehran
1969
Lebanon : AUB
Pap Smears 60s & 70s
Jordan:MOH/JUHKHMC
Pap Smears60’s & 70’s
Saudi ArabiaKFSH/Aramco70’s & 80’s
KHMCFluid Cytology
Cell BlockIHC
80 & 90’s
KHMC1st Local Cytology Workshop:Dr. Erozan
1998
KHCC2nd Local CytoConference:Dr. Sayed Ali
2008
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Pioneers In The Middle EastLandmarks
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Recognizing Landmarks
AUB KFSH7
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Recognizing Landmarks
JHAH
81st & only Cytotechnology School 2006
NGHA
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Recognizing Pioneers
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Recognizing PioneersMiddle East
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•Dr. Janin Tomb: Pap SmearLebanon
•Dr. Mohammad Akhtar•Dr. Ashraf Ali •Dr. Samir Amr
KSA
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Recognizing Pioneers Jordan
Dr. RaghebAl Khalidi
• 1st to introduce cytology
Dr. AsmaTarazi
• Ist trained Cytopathologist
Dr. Salah Al Jitawi
• Cytology Service:
• Gyn/NonGyn• FNA
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My Cytology Journey1985 ‐ Present
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My Road To: The School of Cytotechnology
@ Johns Hopkins
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My Application ProcessSupporting Letters
Mine Dr. Salah Jitawi
Johns Hopkins Cytotehnology
Program
Dr. AquilTutunji
Dr. TheodoreBaramki
Conditional Acceptance 14
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Cytopathology Lab
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Frost Erozan Gupta Staff
Taught By The Giants
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Cytotchnologist’s Work Kit
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Graduation‐1987
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My Career
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Best of Both Worlds
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KHMC/JHH
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NYMC/Quest Diagnostics
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LabCorp/KHCC
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JHAH/MedLabs
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Achievements
Interesting Cases:Slides/Kodachromes
Established CytoSection @ KHMC
FNA ClinicUS/CT Guided FNAs
TeachingCross Training
TBNA @ KHCC
Conferences:Local/International
Invited Speakers:Erozan/Ali
High SchoolCancer/SmokingCareer Days
Interesting Cases:EHE‐PleuralCrypto‐CSF
PCP & CMV‐BALReactive Atypia‐ESWL‐ Urine
ASCP/IACMS: Ovarian Cyst
Cytology
CAP Accreditation:Inspections
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Education for High School Students
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Cancer/SmokingCareer Day
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ASCP‐Dubai/Abu Dhabi
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CAP Inspections
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Challenges
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Challenges
Absence of Cytotechs in Jordan
Shortage of Cytotechs/local in
the Region
Lack of understanding & appreciationFor Cytotechs
* Valuable in all phases of testing
Letting go of H&E stain
Acceptance by Pathologists
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What Worked
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What Worked
Recognized as a field
Volume keeps increasing
Clinician’s buy‐in Diagnostic value is appreciated
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Jordan & King AbdullahUniversity Hospitals
8574 88659327
2292 22763005
2015 2016 2017
Histo Cyto
Cyto Ratio: 22%
JUH10123
10742 11021
2815 2650 2724
2015 2016 2017
Histo Cyto
Cyto Ratio: 20%
KUH
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King Hussein Cancer & Medical Centers
1213211332
13892
40504933 5234
2015 2016 2017Histo Cyto
Cyto Ratio: 27%
18864 1904620399
7127 72098321
2015 2016 2017
Histo Cyto
Cyto Ratio: 29%
KHCC KHMC
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MedLabs
14285
15643 15756
46775375 5104
2015 2016 2017
Histo Cyto
Ratio: 25%35
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What Did Not Work
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What Needs To Improve
Increase # of local Cytotechs
Establishing a School of
Cytotechnology
Cytology Fellowship
Cooperation among
institutions
Utilize Cytology for national programs
Cytology Days:Discuss
interesting cases
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From The World of Cytology What Did I Learn ?
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Team
Leadership Commitment
Support
Break Silos
Openness
Team Approach
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What do you see ?What the mind cannot think of
the eyes can not see
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Diagnostic: Algorithm Approach
Organ
NegAtypPos
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Look For Patterns
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Look for Patterns
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More Common, Then Less Common
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Road MapScreening from one end to the other.
• Up & down then overlapping.• Use 10x for cruising before the actual screening.• Get an overall feeling:
• satisfactory ?.• abnormal cells ?.• microorganisms ?.• other changes ?
CC-1961-05
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Road Map
Evaluate
Background
clean
dirty
other: mucus, colloid
Cell types
normal
abnormalarrangement:single, group
microbes
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Normal Vs. Abnormal
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Normal Cells
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Abnormal Cells
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Faces of Malignant Cells
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Faces of Malignant Cells
Innocent
Follic Neo Melanoma
Ugly
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Faces of Malignant Cells
Muc Ca
SubtleObvious52
HCC
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Faces of Malignant Cells
HDCarc
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Clues are found in nature
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Microorganisms
bacteria
fungi
viruses
parasites
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Cryptococccus neoformans
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Cytomegalovirus: 1 cell
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Proper Smearing Technique
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Proper Collection & Fixation
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HD Clarity
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Take Home Message
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What is Cytology ?
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Art & Science of Interpreting Cells
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What Does A Cytotech Do?
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1963‐200946
I have A Dream
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School of Cytotechnology
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