Board certified

In cytopathology

Thousands

Of FNAs performed and read

12 to 24 hours

Typical preliminary result

One doctor

Biopsy and diagnosis

Celina-M-Nadelman-MD
Who reads your slides

Celina M. Nadelman, M.D.

A board certified cytopathologist specialising in fine needle aspiration. She has performed and interpreted thousands of FNAs of palpable and ultrasound guided superficial masses. At the bedside she evaluates the sample under the microscope on site to confirm the material is adequate, which is why referring doctors usually have a preliminary result within 12 to 24 hours instead of waiting on an outside laboratory.

  • Head of the FNA Clinic for the County of Los Angeles, Martin Luther King, Jr. Outpatient Center
  • Clinical instructor, David Geffen School of Medicine at UCLA
  • Formerly assistant clinical professor, Keck School of Medicine at USC
  • Residency and fellowship at UCLA. M.D., Keck School of Medicine at USC
Why it matters who holds the needle

Most doctors who perform an FNA cannot read it.

An ENT, an endocrinologist, a surgeon or a radiologist can all perform the same biopsy. None of them is trained to read the slide under the microscope, so the sample goes to a laboratory and a pathologist you never meet makes the diagnosis. That handoff is where the delay lives, and where repeat procedures come from.

The usual route

Sample taken, sent away

The specimen leaves the room. If it turns out to be inadequate, the patient comes back for a second procedure, which adds time, cost and anxiety to something that should have been simple.

What changes here

Read while you are still there

Only a cytopathologist can evaluate a slide on site. Dr. Nadelman checks she has enough material before you leave, which virtually eliminates repeat biopsies, then processes and reads the specimen in her own laboratory.

What it buys you

Accuracy, and speed

When the same person performs and interprets the biopsy, diagnostic accuracy increases. A preliminary diagnosis can often be given within hours, which lowers patient anxiety and tells the referring doctor what to do next.

A letter to my patients

“I am honored to have a bit of your time.”

“I know that having a biopsy, no matter how small, can be worrisome and stressful. I am committed to making my patients feel secure and comfortable. Because I have a background in internal medicine, I have experience working directly with people. I am not just sitting in a lab, like most pathologists, looking at slides.”

How I got here

  • I studied psychology and studio art. I was always a visual thinker, and in medical school that arts background turned out to fit pathology, which is a visually oriented discipline.
  • I found FNA in my first year of residency. At a county hospital, and I enjoyed the patient contact, which most pathologists never have.
  • I liked solving the whole mystery. From the first conversation to the diagnosis, rather than receiving a specimen with no person attached to it.
  • I see the patient, not just the slide. A focused history, a physical exam, and the lesion on ultrasound all inform what I am looking at down the microscope.

How I practise

  • I am a one stop shop. I perform the biopsy, check the slide on site, process the specimen in my laboratory and read it myself.
  • I call your doctor. Often within hours of a first look, rather than letting a report make its own way through the post.
  • I try to avoid repeat procedures. Checking adequacy while you are still in the room is the single thing that prevents them.
  • I keep it compassionate and unhurried. A patient centred environment matters as much to the outcome as the technique does.

“When performed by the right, skilled person, an FNA can be a very powerful tool. My goal is to use that tool in a compassionate, patient centred environment, while engaging in open and immediate communication with your referring doctor, to give my patients the best care possible.”

One case, start to finish

A thyroid mass that was not thyroid cancer.

An example of what the streamlined approach actually changes for a patient, in Dr. Nadelman’s own account.

01

The referral

A patient came in with a rapidly growing thyroid mass. The working assumption was the worst case, a poorly differentiated thyroid cancer.

02

The biopsy, and the microscope

She met the patient, performed the biopsy, and looked at the slide herself. It was immediately clear the tissue was not thyroid at all. It was lymphoid.

03

A second sample, on the spot

Right then she took another sample into a separate tube and sent it for the special testing that finding required. No second appointment, no second procedure.

04

The right treatment, sooner

The result came back as Non-Hodgkin B cell lymphoma rather than thyroid cancer. The patient went to an oncologist without delay and chemotherapy began. Surgery was avoided entirely.

About the practice

Questions patients ask first.

What is a cytopathologist?

A pathologist with subspecialty training in diagnosing disease from individual cells rather than larger tissue sections. It is the training that allows the same physician to both take a fine needle aspiration sample and make the diagnosis from it, which is unusual.

Yes, she is board certified in cytopathology. She completed her residency and fellowship at UCLA and received her M.D. at the Keck School of Medicine at USC. She is head of the FNA Clinic for the County of Los Angeles at the Martin Luther King, Jr. Outpatient Center and a clinical instructor at the David Geffen School of Medicine at UCLA.

When the person performing the aspiration is also the person interpreting it, diagnostic accuracy increases and the sample never has to travel. She can confirm on site that there is enough material, which virtually eliminates the repeat biopsies that happen when an outside laboratory finds a specimen inadequate days later.

No. You can schedule directly with the office. If you do have a referring physician she sends them the report and often calls to discuss the findings soon after a first look, so the conversation happens with the person who made the diagnosis.

One doctor, from the needle to the diagnosis.

Next-day appointments are usually available, and house calls are available anywhere in California.

310.702.6701

1125 S. Beverly Drive, Suite 602
Los Angeles, CA 90035
Monday to Friday, 10 to 6