Biomedical Engineering Reference
In-Depth Information
Anette Forss
The (biological) mapping of cells
During screening the cytodiagnosticians made a visual sorting of the cytology
samples by assessing and distinguishing between normal and (potentially)
non-normal cells. Whereas their diagnostic responsibility was 'normal'
cervical cytology, or as they also say 'benign' cytology (I will use the terms
interchangeably), they also marked potentially non-normal cells with the
'dotting thing' (laboratory vernacular for the marking objective on the
microscope) and suggested a diagnosis. The cytodiagnosticians had a refi ned
and differentiated vocabulary for both normal cells and cells that deviated
from the normal and often pointed at a list containing what they referred
to as predetermined 'diagnoses', 'groups', 'classes' or 'codes' representing
scientifi c cytological knowledge about cells. These lists were often kept at
hand during screening, as shown by Anita at Cyto lab:
… see for yourself how many different diagnoses we have. There really
are a lot [she turns towards her desk and shows a paper] and then to
match it right, yes maybe it was only one side (…) No, here you have
almost two pages.
When elaborating on these predetermined classifi cations my informants
said they represented various types of cells, for example 'squamous' or
'glandular' cells. The classifi cations also represented normality, or degrees
of deviations referred to as 'CIN I', 'CIN II' and 'CIN III' that 'originally
belonged' to different cell layers:
… you can fi nd dysplasias, atypias, as you also call them, that is different
types of, degrees of atypia that you can see in cells depending on which
layer of cells and how much they are changed (…) There's an old grading
of mild atypia, moderate atypia, severe atypia, CIN I, CIN II, and CIN III
(…) and as I learned CIN I, it is usually the surface cells, superfi cial cells,
mostly, and then moderate atypia, CIN II, it is mostly those intermediate
cells, if they are atypical. It is not so easy. You learn after a while that
they are intermediate cells and if it's ugly then it must be moderate
atypia, or CIN II (…) and then CIN III are those there, most lowest part
or parabasal cells, you usually see that they show atypia. If you discover
that it is , must be, parabasal cells so it is CIN III. The quantity doesn't
make much difference in this context. It is the type of cells …
(Filippa, Cyto lab)
The diagnosticians not only classifi ed cervical cells in regard to normality
and deviance. They assessed and classifi ed cells in regard to hormone cyclical
changes and patterns on the slide. They could not see the hormones, only
their effects on the cells. They also assessed and classifi ed various species
that were present on the slide, or had affected the cells on the slide. Even
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