Cytology for pathologists: two sides of the same coin or different views of the same side?

Whereas cytology is a branch of pathology and cytopathology services are generally included in the departments and laboratories of pathology, there is often quite a sharp division between surgical pathology and cytology. These traditional divisions reflect different techniques, different problems, different attitudes and sometimes different commitments. Nonetheless these same divisions are becoming less sharp, and more and more artificial. In fact while it was clear since the beginning that cytopathology, and fine needle cytology above all, cannot be performed without a good knowledge of its histopathological bases and the application of ancillary techniques used on corresponding histopathology samples, the awareness of the need for a cytological background among histopathologists is more recent. The size of the samples submitted to the surgical pathology services are smaller and smaller and the applied diagnostic criteria are often more cytological than histological. Even some technical procedures originally specific for the two branches, such as small biopsies and cell blocks or fine needle aspirate smears and cytological scrapings of surgical samples, may be hardly distinguishable. Finally, pushed by clinicians, even the more reluctant histopathologists are often forced to perform diagnoses on cytological samples. For instance, lung pathology is often represented by cytological samples only and important therapeutic decisions on thyroid, breast or other organs are often taken on the basis of cytological reports only. In spite of this, cytopathology is not always exhaustively taught in pathology residencies and postgraduate courses. This tutorial was organized as an attempt to respond to these specific problems and needs. It was organized in three sections, which dealt with the cytopathology of breast, thyroid and lymph nodes. Each section started with a background lecture; then a large and varied selection of paradigmatic cases were shown by the tutors using glass slides and live microscopic projection combined with other imaging and relevant clinical data, followed by discussion. Principal and infrequent pathological entities have been shown, along with their cytological presentations, the diagnostic algorithms, the usage of ancillary techniques and the cyto-histological correlations. Attendees were invited to contribute to the diagnoses in a relaxed atmosphere. They were encouraged to take part in the discussion, focusing on differential diagnoses, the possibilities and limitations of cytology in the specific cases and the clinical implications. To ensure that all the attendees had the opportunity to participate interactively, the tutorial was offered to a limited number of participants. Digital copies of the introductory lectures and a final diploma from the European School of Pathology (ESoP) were issued to the participants. Organizers received excellent feedbacks and future tutorials will be scheduled in the next years.