Learn more about Nail Alouch, MD, a Cytopathology Fellow Member of the ASC and our Member Spotlight of the month, from his conversation with Membership Committee member Aileen Arriola, MD.
Nail Alouch, MD
MD Anderson Cancer Center
Interviewed by: Aileen Arriola, MD
MD Anderson Cancer Center
- How did you first find out about cytology?
In medical school, I was amazed by the fact that over a short period, cervical cancer has become one of the most preventable diseases, after it was one of the most lethal GYN malignancies. This was the result of a very simple, non-invasive, cost and time-efficient test called the “Pap smear”. The simplicity, intelligence, and potential of this test in nearly terminating advanced stages of cervical cancer made me realize how cytology can be a valuable method in the future.
- What drew you to this profession?
Cytology can give valuable diagnostic information with the least amount of sample; yet, it can also provide therapeutic options with the advanced molecular testing for targeted therapy. I believe that cytology is becoming an essential player in patient care and it will be an irreplaceable factor in our daily practice.
- Tell us about an interesting case or situation that you have encountered in your practice.
I recently had a fine needle aspiration of a liver mass for a patient with prostatic adenocarcinoma. On immediate assessment, the smears showed many clusters of epithelial cells that were predominantly arranged in glandular forms. The cells had prominent nucleoli and abundant cytoplasm. The initial impression was that the lesion is consistent with patient’s known prostate primary. However, on further review of the smears, there were focal areas that showed cord-like/trabecular arrangements with endothelial wrapping. The cell block showed glandular structures and more of the thickened cords/trabeculae. Immunostains were negative for prostatic markers, and the tumor cells were positive for hepatocytic markers, and the diagnosis of hepatocellular carcinoma was made. This case made me further believe that it is crucial to keep an eye on the cytologic features, which can be substantial and may impact the patient’s management.
- What do you like best about being a cytopathologist?
I like being able to perform fine needle aspirations. Cytopathology is one of the few fields in pathology that has direct patient contact. When doing the procedure, I like talking to patients and knowing more about their lesions and having a list of differential diagnoses before performing the procedure. In addition, I really enjoy it when the smears correlate with my thoughts. Another thing that I like about being a cytopathologist is the art of being able to recreate histologic architecture from clues on the smears (which may be subtle). This skill makes cytopathologists have strong knowledge of histologic patterns of diseases.
- What do you value most about your membership in the ASC?
There are many benefits from being an ASC member. I like being able to access all the educational resources. Cases Studies and Cell Talks are my favorite. The articles and material in the eJournals are also very useful. ASC membership makes you a member of a larger family where you can make new friends and share experiences with others.
- Do you have a memory from the ASC that you would like to share?
The ASC Annual Scientific Meeting has its own charm, which makes it one of my favorite meetings. My favorite thing about the ASC Meeting is that it has the perfect balance of learning, networking, and fun. The Scientific Sessions, Workshops, and Platform and Poster Presentations are exceptional. The discussions always have great impact on our daily practices whether we are in academic or private practice settings. Additionally, the ASC is a very well connected society, which makes the Meeting a great opportunity for networking and making new friends and colleagues. Moreover, the Meeting does not lack entertainment. The last Meeting I attended in Phoenix, AZ had a very successful and fun session that everyone enjoyed called Cytology Shark Tank!
- What advice would you give to students coming into the profession?
Cytopathology is a great field and is progressing day after day. My advice is to keep updated on the new topics and advances in cytology and to improve your skills to become a better cytotechnologist/cytopathologist. Also, it is important to train your eyes to always look for the details, because that’s the key for cytology.