I. What is the most important purpose of intraoperative freezing? To provide a basis for the choice of surgical procedure. It is more important to advise the surgeon what to do next than to give a specific pathological diagnosis. Why is it necessary to make an appointment for intraoperative freezing one day in advance? Notifying the pathologist one day in advance gives him/her time to read and familiarize with the medical records and imaging data, and even to see the patient clinically to be fully prepared, which helps to improve the diagnostic accuracy of freezing. Third, what is the scope of caution in using intraoperative frozen pathology? Specimens involving amputation and other radical surgical resections that would be severely disabling. For patients requiring such surgical treatment, the nature of the lesion should be determined by routine biopsy before surgery. The scope of application of intraoperative frozen pathology is not suitable for 1. suspected lymphoma; 2. specimens that are too small; 3. specimens that are suitable for routine biopsy before surgery; 4. adipose tissue, bone tissue and calcified tissue; 5. soft tissue tumors that need to be judged as benign or malignant based on nuclear schizophrenia counts; 6. tumors that cannot be judged as benign or malignant based on tissue morphology but mainly on the characteristics of tumor biological behavior; 7. specimens that are known to be infectious (tuberculosis, viruses, etc.). Specimens known to be infectious (tuberculosis, viral hepatitis, AIDS, etc.). V. What is the role of immunohistochemistry? 1. To help identify the origin of tumors, especially lymphoma and soft tissue tumors; 2. To help identify benign and malignant by using tumor-associated antigens, but the role is very limited. In short, immunohistochemistry and other techniques play an auxiliary and reference role for pathological diagnosis. What should be noted when sending pathological specimens for examination? 1.Specimens should be sent intact, not dissected by themselves; 2.Specimens from different parts should be packed in separate bags; 3.Clinicians should fill out the pathology application form truthfully, in detail and in place, and sign it by hand; 4.Pathology diagnosis is made according to the specimens sent for examination, and pathologists are not responsible for the authenticity of other clinical information provided by patients such as name, gender and age. 5.Routine pathology reports are for clinicians’ reference in diagnosis, and cannot be used as other proofs. It cannot be used as other evidence. Why is clinical information important for pathology diagnosis? The close integration of pathology and clinic can bring the role of pathology diagnosis to the maximum. Gender, age, medical history, clinical manifestations, intraoperative or endoscopic findings, specimen condition, sampling site, diagnostic imaging and laboratory tests all have important reference roles in pathological diagnosis. Pathologists sometimes have to “clinically” see the patient, or at least look at the medical record. Eight, how is the pathological diagnosis arrived at? 1. pathological examination of patient specimens; 2. pathologist’s theoretical knowledge of pathology, relevant technology and personal professional practical experience; 3. combined with relevant clinical data and other clinical examinations; 4. analyzed and synthesized to arrive at a well-founded subjective judgment. IX. What are the types of pathological diagnosis? (a) Definite diagnosis: e.g., chronic cervicitis; (b) Opinion diagnosis: e.g., a small amount of heterogeneous lymphocyte infiltration in the lymph nodes (right neck), which may be leukemic changes, and it is recommended to check the blood and bone marrow images to further confirm the diagnosis; (c) Descriptive diagnosis: e.g., a small amount of broken endometrium in the clot (scraping) and inflammatory cell infiltration in the interstitium; (d) Negative diagnosis: e.g., only a small amount of epithelial tissue and a small amount of epithelial tissue in the tissue sent for examination. If only a small amount of epithelial tissue and severe degeneration is seen in the tissue sent for examination, please retake it for examination. Ten, how to read the pathology report? (a), the prefix has a meaning: indicates that the diagnosis is not certain, not completely sure. 1. highly considered (for): > 90%; 2. considered (for): 80-90%; 3. suspicious (for): 60-80%; 4. consistent (for): a doctrine that 40-60%. Another doctrine that it should indicate 80%; 5. Not excluded, not excepted: <20%; 6. Other: tend to (in), preferred, please except, to be excluded, may be, suggested. (b), suffixes with hints: 1. invasion of the envelope (consider ...), please note the review (follow up). 2. unclear structure, please (if necessary) retrieve and send for examination. 3. poorly fixed (better) tissue (cells). 4. please combine with clinical diagnosis. 5. "?" indicates suspicion, e.g., cervicitis with erosion? (c) Brackets have said: The name of the specimen or the site of sampling on the brackets, indicating that it was taken by the clinician. The pathologist is only responsible for the microscopic diagnostic results, and is not responsible for whether the site matches the actual. For example: (gastric sinus) adenocarcinoma; (nasopharynx) poorly differentiated squamous fine carcinoma. (d) The disease name has basis: the diagnosis is made according to the name of the disease in the book. "WHO Classification of Tumors" is the authority. XI. How is the difficulty of pathological diagnosis graded? 1. Textbook level: The lesion is typical. It is documented in the textbook. The diagnosis must be clear. General pathologists should be able to see it; 2. Difficult level: It is enough to make a correct diagnosis in a wide range, such as determining benign and malignant. The pathologist should be able to see it; 3. Controversial level: Different pathologists have different diagnoses. May not make a clear diagnosis. Twelve, why do you say that the pathology diagnosis is becoming more and more difficult? 1.The more detailed the surgery is done, the more pathological items; 2.The biopsy specimens are getting smaller (puncture), more fragmented (lumpectomy), more burnt (electrodesiccation); 3.The patient's awareness of rights is getting stronger, and the legal role of pathology report is getting bigger; 4.The accuracy and scientificity of pathological diagnosis is getting higher and higher. Thirteen, why is it said that pathologists have one foot in the hospital and one foot in court? Pathologists' diagnostic errors are very harmful. Clinical errors are like driving a car in a car accident but light, pathology errors are like flying a plane crash but less heavy. Iron slices, running water pathologists, the generation is more demanding than the generation. The microscopic field of view remains unchanged, and the diagnostic criteria change with the times. Pathology reports often play a key role in medical litigation. Fourteen, why is the pathology gold standard has limitations? Pathological diagnosis is not a panacea. It can only diagnose those with morphological changes. Reflects only changes in disease stage. Subject to the degree of specimen representation. Only reflects the level of knowledge and standard at that time. There is uncertainty, especially in junctional lesions.