Cytopathology

Cytopathology Exam Description

The examination in cytopathology is a one-day, computer-based examination consisting of combined Written and Practical sections and Virtual Microscopy (VM) sections. There are no glass slides, only VM. The examination is administered as follows:

All questions are multiple-choice, single-best answer format. The questions assess the candidate’s body of knowledge, judgment and problem-solving ability. The practical questions include interpretive and problem-solving aspects of cytopathology, including clinical, radiologic and histologic correlation and management guidelines. The written questions include factual, administrative, technical, and regulatory aspects of cytopathology, systems-based practice, and patient care. The virtual microscopy examination requires using locator skills, diagnostic interpretation, and correlation with histologic findings. Typically, the cervical/anal cytology slides will be dotted; FNA and non-gynecologic slides are usually not dotted.

Exam content areas include, but are not limited to:

Gynecologic/Anal Cytopathology

• Sample collection, preparation, automation, and ancillary testing (HPV testing, genotyping, and Immunocytochemistry/ICC)
• Morphology of normal, reactive, infectious, and epithelial abnormalities
• Bethesda System terminology for reporting cervical cytology, WHO/LAST recommendations for histopathology reporting of HPV associated squamous lesions of the lower anogenital tract.
• Primary prevention of cervical cancer- HPV vaccination
• Secondary prevention of cervical cancer: current screening and management guidelines from key organizations (ACS, USPSTF, ASCCP, ACOG, etc.)

Non-Gynecologic and Fine Needle Aspiration Cytopathology

• Includes specimens obtained from all body sites
• Specimen collection (techniques, indications) and processing

• • FNA/ core biopsy procedures
  • Specimen types-direct smears, liquid-based preparations, cell blocks, core biopsies, crush/squash preparations and touch imprints of core biopsies, gross specimen scrapes.
  • Stains – familiarity with air dried Romanowsky, alcohol fixed Papanicolaou, and H&E stained preparations is expected.

• Specimen types-direct smears, liquid-based preparations, cell blocks, core biopsies, crush/squash preparations and touch imprints of core biopsies, gross specimen scrapes.

• Morphology of normal, reactive, infectious, and neoplastic/malignant entities
• Standardized cytopathology reporting terminology recommendations for thyroid, salivary gland, pancreaticobiliary, breast, urinary, serous fluids and respiratory cytology, lymph node, bone and soft tissue
• Ancillary studies (histochemical /immunohistochemical stains, flow cytometry, molecular, cytogenetic, and genomic testing)
• Includes applicable

• • Clinical presentation, radiologic findings, disease associations, and prognostic significance
  • Pathogenesis, epidemiology, molecular/genetic changes
  • Cytologic-histologic correlation
  • Clinical management including applicable professional guidelines (e.g., ATA etc.) and targeted therapies/ companion and complementary diagnostics

Laboratory Management/Administration

• Cytopathology laboratory accreditation requirements
• Quality assurance, safety, test validation
• Federal laws and agency regulations
• Billing and coding relevant to above content
• Statistics relevant to health care
• Informatics, digital pathology
• Physician credentialing, continuing certification, litigation in pathology

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