Celina M. Nadelman, MD

Celina M. Nadelman, MD Fine Needle Aspiration Specialist. Fast, Accurate, Compassionate: A Superior Way to Biopsy like Dr. Nadelman.

Having performed over 12,000 FNAs, Dr. Nadelman is both a board certified pathologist and cytopathologist, able to:

1) perform the biopsy
2) immediately evaluate the biopsy
material in the adjoining lab

Having one of the highest rates of obtaining "diagnosable" samples on the first effort, virtually eliminating the need for repeat biopsies, there are only about a dozen specialists in the entire U.S.

A surprising Easter connection in pathology.This time of year, we often think of bunnies and new beginnings. Under the m...
04/05/2026

A surprising Easter connection in pathology.

This time of year, we often think of bunnies and new beginnings. Under the microscope, a thyroid sample showed features that resembled a bunny. Sometimes even serious work can occasionally reveal something unexpected.

Of course, while this visual comparison brings a smile, the focus is always on accurate diagnosis and patient care. Early detection and expert evaluation play a key role in guiding the right treatment and helping patients move forward with confidence.

If you have questions about thyroid nodules or biopsy evaluation, we’re here to help. https://drnadelman.com/thyroid-cancer/

Happy Easter!

🔬 | Intervening Keratinizing Squamous Cells | A Closer Look at Diagnosis in ActionIn this case, the cellular smears sh...
03/23/2026

🔬 | Intervening Keratinizing Squamous Cells | A Closer Look at Diagnosis in Action

In this case, the cellular smears show enlarged squamous cells with striking orange cytoplasm. That orange hue is not incidental. It indicates keratinization, meaning the cells are producing keratin, the structural protein found in skin, hair, and nails.

On the left side of the image, there is a bluer, tightly cohesive group of cells with higher nuclear to cytoplasmic ratios. These cells appear more crowded, with larger nuclei relative to the amount of cytoplasm. Intervening between these groups are keratinizing squamous cells, adding another layer to the microscopic picture.

When evaluating squamous lesions, features such as keratinization, nuclear size, cellular cohesion, and background elements all help determine whether the process is reactive, precancerous, or malignant. Careful cytologic interpretation is essential because subtle differences can significantly change the diagnosis and subsequent management.

What do you notice first in these slides?

🔬 | Melanoma | A Closer Look at Diagnosis in ActionA 61 year old man presented with a three month history of a mass on...
03/16/2026

🔬 | Melanoma | A Closer Look at Diagnosis in Action

A 61 year old man presented with a three month history of a mass on his upper thigh. During his initial visit to an internist, it was thought to be a lipoma, which is a common and typically benign fatty tumor. Lipomas are soft, mobile, and often harmless, so they are frequently observed rather than biopsied right away.

A Fine Needle Aspiration was performed to better understand what the mass truly represented.

Under the microscope, the cellular features told a very different story. Instead of benign fat cells, the sample revealed malignant cells consistent with melanoma. Melanoma can sometimes mimic other soft tissue masses clinically, especially when it presents outside of the typical skin lesion most people associate with it.

This case is a powerful reminder that not every soft tissue lump is benign, even when it appears clinically straightforward. Microscopic evaluation provides the clarity needed to guide appropriate treatment decisions early.

What factors would make you reconsider a presumed lipoma?

🔬 | A Closer Look at Diagnosis in ActionIn this case, moderately cellular smears show tightly cohesive groups of macro...
02/23/2026

🔬 | A Closer Look at Diagnosis in Action

In this case, moderately cellular smears show tightly cohesive groups of macrophages alongside scattered single macrophages. There are also flat honeycomb sheets, staghorn, and papillary-like tissue fragments composed of mildly atypical epithelial cells.

These epithelial cells demonstrate high nuclear to cytoplasmic ratios, small but distinct nucleoli, and relatively scant cytoplasm. Rare myoepithelial cells are intimately associated with the epithelial groups, and scattered naked nuclei are present in a background of old blood and cystic fluid.

What does this constellation of features suggest?

The overall pattern supports a proliferative breast lesion with mild atypia, which can include entities such as fibrocystic change, usual ductal hyperplasia, papillary lesions, or fibroadenomatosis. These findings are not outright malignant, but they are not entirely benign either. Careful cytologic interpretation and clinical correlation are essential to determine appropriate next steps.

Breast cytology often requires distinguishing subtle architectural and nuclear features that guide management decisions. This is where experience in both performing and interpreting FNA becomes especially important.

When looking at these images, what stands out to you first?

🔬 | A Closer Look at Diagnosis in ActionThis patient presented with a slightly red mass on his back and was also found...
02/16/2026

🔬 | A Closer Look at Diagnosis in Action

This patient presented with a slightly red mass on his back and was also found to have a kidney mass. Because of the kidney tumor, there was concern that the back mass could represent metastatic disease. Chemotherapy was being considered.

Before treatment decisions were finalized, a Fine Needle Aspiration was performed on the back mass. Under the microscope, the slide was highly cellular. You can see predominantly purple cells with intervening blood and fat. The cells show vacuolated, bubbly cytoplasm and enlarged nuclei with visible nucleoli.

Here is where it becomes diagnostically challenging.

Renal cell carcinoma can look very similar under the microscope. The cytologic features overlap, and without careful evaluation and clinical correlation, the lesion could easily be interpreted as metastatic kidney cancer.

The mass was eventually excised, and the final diagnosis was sebaceous carcinoma, a rare malignant tumor arising from oil glands in the skin. This case highlights how critical tissue evaluation and stepwise diagnosis are before initiating systemic therapy.

Microscopy is not just about what cells look like. It is about asking the right questions before making life-altering treatment decisions.

What features stood out to you?

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1125 S Beverly Drive #602
Beverly Hills, CA
90035

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