Cytology:  Diagnostic Principles and Clinical Correlates –  5th Edition
Edmund S. Cibas, MD

Barbara S. Ducatman, MD
2021 Elsevier Inc.
575 pages

As the field of cytopathology continues to grow and evolve, Drs. Cibas and Ducatman have published the fifth edition of “Cytology: Diagnostic Principles and Clinical Correlates.”  Each edition has built on the strength of the previous editions with adding new topics and this book exceeds the standards already set.  The fourth edition included a dedicated chapter on fine needle aspiration (FNA) technique and specimen handling with a video demonstration attached.  A chapter on bone cytology is a welcome addition to this edition.

As the authors note, the chapters are written by many authors and even so, the chapters follow a similar format.  The basic format of the chapters is laid out in the preface and is as follows:

  • Indications
  • Sample collection and preparation methods
  • Terminology for reporting results
  • Accuracy (including common pitfalls that lead to false-negative and false-positive diagnoses)
  • A description of normal elements
  • A “how to” guide for diagnosis of benign and malignant lesions with an emphasis on differential diagnoses.

As with most cytopathology textbooks, the authors begin with a chapter on gynecologic cytopathology, which builds the basis of cellular morphology in cytology both benign and malignant.   Other areas of exfoliative cytology are discussed in similar structure and design.

As mentioned above, an entire chapter is devoted to FNA techniques discussing the performance of the FNA to include ultrasound-guided FNA as well.

Cellular criteria for normal elements as well as benign and malignant lesions are provided in the didactic session of each chapter.  The authors also utilize bulleted “capsule summaries” for highlighting specific cytomorphologic features of various entities as well as the differential diagnoses.  These capsule summaries are also useful in depicting various features unique to the subject matter at hand.  For example, in the salivary gland that are capsule summaries depicting the following:

  • Tumors that are often cystic
  • Lesions that are sometimes bilateral
  • Numerous lymphocytes are seen in

These summaries provide an easy and quick reference guide when you may not have the time to read through the entire chapter to locate the information you need.

There are numerous images in each chapter depicting the various cytologic criteria, histology, immunohistochemistry (IHC), flow cytometry, and molecular diagnostics for various benign and malignant lesions.  Each cellular image is clear and demonstrates the lesion or topic discussed.  The captions for each lesion provide additional detail notes for the specific criteria illustrated.  Tables are also included in each chapter where appropriate to show IHC results for specific lesions as well as other topics that lend themselves easily to a table format.

The final chapter in this book deals with laboratory management.  There are wide ranges of topics discussed from cytopathology organizations to regulatory agencies.  The federal regulations revolving around gynecologic cytopathology is discussed at length to include proficiency testing, laboratory personnel standards and screening workloads.  Various laboratory accreditation requirements are provided as well as laboratory safety standards.

The fifth edition of this book is excellently written and organized.  It is hard to imagine another edition being better than the one before.  This edition does not disappoint-it continues to build on excellent knowledge and organization.  This book is highly recommended as the go to textbook for all of your cytologic inquiries.


Leigh Ann Cahill BS, CT(ASCP)CMIAC
Editor, The ASC Bulletin
American Society of Cytopathology