”Clinical medicine, first and foremost diagnosis”, a correct and comprehensive diagnosis is the prerequisite and necessary condition for correct treatment. We often encounter such patients, saying that after the imaging examination, the doctor said that the imaging diagnosis is a certain disease, and the clinical expert has seen it and diagnosed a certain disease, while the pathology diagnoses another disease, who do we believe? This involves the question of how to look at the pathological diagnosis versus the clinical diagnosis. What is diagnostic imaging? As the name suggests, it is a diagnosis given by an imaging physician after an imaging examination (e.g., ultrasound, X-ray, CT, MRI, PET/CT), based on what is seen in the imaging examination and combined with relevant disease information. The accuracy of diagnostic imaging is affected by many factors, such as the typicality of the imaging changes of the disease, the diagnostic experience of the imaging doctor, etc. What is clinical diagnosis? Clinical diagnosis is a diagnosis made by a clinician after comprehensive analysis based on various clinical information, such as medical history, physical signs, physical examination, biochemical examination results, imaging findings, etc. The accuracy of clinical diagnosis is also influenced by many factors, such as the completeness of clinical information, the typicality of clinical manifestations, the obviousness of biochemical and imaging changes, the diagnostic experience of clinicians, etc. Although biochemical, immunological and imaging diagnoses of tumors have been greatly developed, pathological diagnosis is still the main factor to determine the nature of tumors. Pathological examination is one of the most accurate and reliable methods to diagnose tumors. Pathological diagnosis refers to the application of theories and techniques of pathology to make disease diagnosis by morphological observation and analysis of diseased tissues and cells taken from the organism. It is the most essential judgment of the disease, the “gold standard” of diagnosis, and the “final judgment” of the disease. The diagnosis of any imaging doctor or clinician is only based on the clinical symptoms and signs of the patient and the maximum statistical probability after the appearance of the symptoms and signs, and the accuracy is only probable for a certain patient. Nowadays, the disease onset is getting earlier and earlier, and the symptoms and signs are becoming more and more atypical. A large number of foreign retrospective data show that the accuracy of the diagnosis made by the clinician after questioning and physical examination is between 50% and 60%, and the accuracy after combining imaging and laboratory examination is between 70% and 80%; while the accuracy of pathological diagnosis is between 95% and 99.8% (must be fully The current situation in China is that clinical information is not well provided to pathologists). However, pathological diagnosis also has limitations. The pathological diagnosis can only be made by slicing and diagnosing what is sent by the clinician, relying on morphological changes that do not fully reflect the essence of the disease, and is a subjective process of judging the objective, and differences and discrepancies are inevitable and closely related to the professional level of the pathologist. Therefore, strictly speaking, there is no real diagnostic “gold standard”, but only infinitely close to the essence of the disease! Finally, the clinical-pathological combination must be closely integrated, with dynamic clinical observation, immediate pathological examination when lesions are taken, careful pathological observation, more relevant auxiliary examinations, and frequent discussions between clinical and pathological doctors, in order to finally grasp the essence of the disease and get the correct diagnosis!