By Lynn McCain 
 

A patient’s biopsy or other tissue sample passes through many hands on its way from the patient to the diagnosis. In many cases, the physician and nurses with the patient pass the tissue along to those who prepare it for transport to the laboratory. The transporter delivers it to the specimen processing area, where lab techs check it in and ensure all the details are correct and the specimen meets criteria for testing. It then passes to the histotechs who process the tissue into paraffin blocks, slice the tissues on a microtome, and prepare the glass slides, which are stained for viewing. The slides are taken by another laboratory tech and digitally imaged for viewing by pathologists, residents, and fellows. Finally, the diagnosis is made, and the report returns to the physician and the patient.

The histotechs play a key role in this process. The speed and quality of their work determines whether the correct diagnosis can be made in a timely manner. To learn more, we recently sat down with Benjamin (Ben) Reed, ASCP (HT) and Ciana Swasey to follow their paths to this career and to discover why this career path is so fulfilling.

Ben graduated from the University of Michigan with a degree in Movement Science and fell in love with Ann Arbor as a student. After graduation, he ended up coaching Cross Country in Wisconsin, but wanted to return to Ann Arbor. He found a position as a research assistant at U-M, and in April 2021, transferred to a position as a lab tech in pathology. “I didn’t know a lot about pathology at the time, but once I got my foot in the door, I learned so much. I decided I wanted to get certified so I could do more.” Ben was working as a lab tech in the frozen section lab and supervisor Kelli Farhat supported him in this goal. She gave him study materials so he could prepare for the histotechnician (HT) certification. He studied hard, was mentored in the laboratory, and passed his HT certification exam in January 2024.

Ciana followed a slightly different path. She pursued her undergraduate degree at Wayne State University and was interested in becoming a pathologist assistant. She began shadowing one of the PA’s, Matt Gabbert, and became very interested in pursuing a career in pathology. In November 2021, she joined the lab as a laboratory technician. When she saw what the histotechs did, she developed an interest in the field. “I expressed an interest in histotechnology, and Kelli Farhat and Karen Barron introduced me to the training program through Indiana University. I applied for the program, and I got in. I started in August 2023 and just finished in May.” Ciana will be sitting for her histotechnologist (HTL) certification examination in the near future, which is being paid for by the Clinical Pathology Staff Enhancement Fund. This is the highest-level certification for histotechs. We wish you great success, Ciana!

Ben’s role as a histotech is a bit different than that of others working in the laboratory as he works in the frozen section lab. In this unit, tissues are flash frozen while the patient is in surgery. Ben then needs to quickly embed the tissues in OCT (optimal cutting temperature compound), prepare and stain the slides for pathologist review with a <20-minute turnaround time, while the patient remains under anesthesia in the operating room. This enables the surgeon to know whether the entire tumor had been excised. If tumor is fully excised, the slide will show clear margins - with no tumor cells present. If not, then the surgeon needs to take a little more tissue and the process is repeated until the slides show clear margins. This is a high-pressure role that requires speed, accuracy, and great attention to detail, along with an unflappable nature. Ben excels in this role.

Ciana is currently transitioning from her laboratory tech position in Surgical Pathology to the histology tech position, which she starts next week. She will be working in the NCRC laboratory embedding tissues, cutting blocks, preparing slides and staining them. Her position handles the vast quantities of specimens that arrive in our labs daily. While the pressure to turn a specimen around quickly due to someone being on the operating table is not present, the pressure to process high volumes of specimens is still there.

“I like to be able to help ensure the patient is clear of cancer. Every block we prepare and every slide we stain is like a person. It is important, it could be a member of your family,” Ben stated as he explained his passion for the job. “And there are so many good people on the job. I enjoy working with the residents, fellows, and attendings. We have such a good team here at U-M. Everyone is always helping each other.”

“I agree,” said Ciana. “Knowing that I am making such a big difference for the patient, making sure that everything is processed how it should be and that it is not held up, is so important. I make sure patients are getting their results and a diagnosis in a timely manner. It is very rewarding.”

Now that Ben and Ciana have taken the step toward certification, what is next? “I am moving from the University Hospital core lab to the North Campus Research Complex laboratory,” said Ciana. “Having the certification just opened up a lot of doors to be able to advance in our careers,” explained Ben. “We get paid more – which is always a good thing – and we will have more opportunities now.” “I am looking forward to being able to grow within Pathology. I feel like getting my certification will be my steppingstone. Now I can be a histotech and maybe someday I will become a supervisor in histotechnology,” Ciana added.

If you want more information on how to become a histotech in Pathology, contact our Allied Health Education Program Manager, Karen Barron at karbarro@med.umich.edu.