Cytopathology is the Anatomic Pathology subspecialty involved with the study of individual cells. Our division encompasses both Exfoliative Cytology and the Fine Needle Aspiration Biopsy Service.

The Exfoliative service includes Gynecologic cytology (Papanicolaou tests), as well as the examination of body fluids (such as pleural, pericardial, peritoneal and cerebrospinal fluids), respiratory and urinary specimens. Our state of the art core laboratory processes both liquid-based and conventional pap tests with on-site ancillary testing for Human Papilloma Virus (HPV).

The Fine Needle Aspiration (FNA) Biopsy Service is active in the performance of superficial FNAs for outpatient and hospital patients. We see patients in our clinic and perform biopsies of palpable lesions as well as with the use of ultrasound for thyroid and other sites. We also provide rapid on-site interpretation for FNAs performed by interventionalists in other specialties. Diagnostic results are generally available within 24-48 hours. We routinely utilize other Duke University Health System laboratories to perform immunohistochemistry, flow cytometry, molecular diagnostics and cytogenetics on FNA samples, and issue an integrated diagnostic report.

For Patients, please see this explanation of the FNA process.

All the Cytopathology faculty are certified in Cytopathology by the American Board of Pathology, and routinely work with both exfoliative and FNA cases. We have a long-standing ACGME accredited Cytopathology fellowship program.


Danielle Range, MDis Division Director and ABP board certified in Anatomic Pathology and Cytopathology.

Sarah M. Bean, MD, is a Cytopathologist and Breast and Gynecologic Surgical Pathologist who specializes in women's health care.  Since 2006, she has provided excellent patient care at Duke.  She is also a passionate medical educator, involved in graduate medical education (GME) and continuing medical education (CME). Her current scholarly interests include human papillomavirus (HPV), p16, GME, feedback, competence, milestones, professionalism and generational differences in learners.

Raj C. Dash, MD,  is a board-certified pathologist with fellowship training in Cytopathology and Informatics.  He currently serves as the Beaker Physician Champion and Director for Laboratory Informatics Strategy.  He has an undergraduate degree in computer science and specializes in medical informatics, fine needle aspiration cytology and surgical pathology of breast cancer.  Dr. Dash is active on a number of national committees serving the College of American Pathologists, including the Informatics Committee (serving as chair). 

Rachel E. Factor, MD, is the section head of breast pathology. Her expertise is in both breast pathology and cytopathology. Her research primarily focuses on providing pathology expertise to a range of mulstidisciplinary and multi-institutional collaborations seeking to improve our understanding of the biology and detection of breast cancer. Additionally, she has interests in quality assurance improvements in breast pathology laboratory testing, and is passionate about mentoring and fostering the academic growth of residents and fellows in surgical pathology and cytopathology.

Wen-Chi Foo, MD,  is a board-certified cytopathologist and surgical pathologist specializing in genitourinary pathology.  Her research interests broadly center on identifying molecular markers with high diagnostic and prognostic utility, as well as investigating the application of new technology to pathology specimens.  This includes investigating how current knowledge of molecular mechanisms of oncogenesis and tumor progression can be exploited to improve diagnosis in fine needle aspiration biopsy, as well as application of deep learning to the diagnosis of prostate cancer in surgical pathology specimens.

Xiaoyin "Sara" Jiang, MD,   is an Associate Professor of Pathology specializing in cytopathology and surgical pathology.  Her areas of expertise include fine-needle aspiration biopsy, cytopathology, and thyroid neoplasia. She is Chief of Head and Neck and her diagnostic work spans the areas of cytopathology and surgical pathology of the head and neck and endocrine systems.  Dr. Jiang's research focuses broadly on improving diagnosis and prognostic markers on surgical and cytopathology samples, specifically in the endocrine and head/neck areas. Her research efforts have centered on cytopathology performance and improving diagnosis and prognosis of thyroid carcinoma. Specific areas of study include, 1) performance of cytopathology and fine needle aspiration biopsy, 2) the performance of ancillary and molecular diagnostics to enhance diagnostic accuracy in fine-needle aspiration biopsy, and 3) molecular determinants of tumor aggressiveness. Additional interests include medical education and professional use of social media in medicine. Follow her on Twitter @Sara_Jiang.

Avani Pendse, MD, PhDis an Assistant Professor of Pathology specializing in gastro-intestinal and genito-urinary surgical pathology and cytopathology. Dr. Pendse completed her residency, cytopathology fellowship and surgical pathology instructorship at UNC, Chapel Hill and came to Duke in 2017. Her research pursuits include investigation to improve the morphologic and proteomic based understanding of gastro-intestinal disease. In her role as the Associate Director of Proteomics of the Duke BioRepository and Precision Pathology Center, she is currently focused on developing multiplex immunohistochemistry panels to study immunologic and oncologic diseases.