In the process of fighting against diseases, Ruijin has always moved forward bravely, creating countless miracles and accumulating many original experiences. It is precisely because of the successful treatment cases that Ruijin has become a hospital that today is trusted by patients, pride of employees, respected by peers, and satisfied with society.
I am a young pathologist . Every day, I carefully observe the lesions of different diseases under a microscope, and I have issued pathological diagnosis reports that are known as the "gold standard" for disease diagnosis. Pathological diagnosis is known as the "judgment of life". I have met patients who fainted because they got a pathological diagnosis report diagnosed as malignant tumor, and I have also seen patients who dance happily and cry with joy due to the "cancer-free judgment"... From the day I became associated with the pathology, the teacher told me that behind each pathological diagnosis is the course of the fate of a patient and a family. We are doing things that are "human life is at stake", so we need to be serious, serious, and more serious.
Today, I will share with you a warm story behind the pathological diagnosis.
On this day, in the expert clinic of our director of the pathology department, Professor Wang Chaofu, came a quiet and delicate girl named Xiaoxing (pseudonym). I read the medical record and I just turned 23 years old and I am still a graduate student in school. Maybe because of my condition, my face was a little pale. After consultation, I learned that Xiaoxing had never had sex and had not had menstruation for half a year, and her breasts were still secreted. This "strange disease" made the whole family anxious. , a local hospital's magnetic resonance examination, showed that there was a tumor in the saddle area of Hyosung's brain, and the doctor recommended surgical resection. In order to determine the nature of the tumor, the doctor conducted a rapid pathological diagnosis of cryosing sections for Hyosung during the operation, and based on cryosomal sections, it was diagnosed as "spindle cell hyperplasia with vascular hyperplasia, meningioma waiting to be discharged". The routine postoperative pathological diagnosis result was "(intrasalpa) small cell malignant tumors accompanied by the hyperplasia of crude fiber connective tissue in the interstitial tissue. However, due to limited technical conditions, further diagnosis cannot be further clarified." The doctor told Xiaoxing and his family that there will be a huge difference in treatment methods and prognosis for tumors of different natures. It is recommended to go to a better hospital to seek answers and then take the next step of treatment.
So, Xiaoxing and her family took pathological section to the authoritative hospital she believed. However, because Xiaoxing's lesions were too special and the lesion was unclear. After repeated observation of the pathological sections, the doctors tended to lymphogenic hematopoietic malignant tumors, but could not make 100% sure diagnosis. You should know that the treatment plans for meningioma and lymphoma are completely different. In this case, clinicians dare not start treatment rashly. But everyone knows that whether it is meningioma or lymphoma, if it can be diagnosed one day in advance, it will be precious for subsequent treatment. Finally, after inquiring from many sources, Xiaoxing and his family took the slices and came to Ruijin Hospital with a nervous mood to ask for a rescue consultation for the Chaofu.
Director Wang Chaofu patiently asked Xiaoxing about his condition and comforted her and her family. After the outpatient clinic, Director Wang took us with us and began to carefully observe and analyze Xiaoxing's pathological section lesion under the microscope. The cell scald caused by electrocution during the operation is indeed very serious, and it is difficult to see the lesion clearly. It is indeed necessary to accurately identify the lymphohematopoietic system diseases. Then he made immunohistochemical marks (necessary for diagnosis). After the immunohistochemical marks were sliced, Professor Wang Chaofu pondered and considered under the microscope, and observed that the immunohistochemical TDT antibody was positive. At that time, I heard him muttering to myself: "The site of the patient's lesion is in the skull, and there are some small lymphocytes in the stromal stromal. What are the non-lymphoblastic hematopoietic system lesions that can express TDT? Germ cell tumors, thymoma , small cell carcinoma..." After a brief silence, the director suddenly said in a positive tone: Could it be an intracranial germ cell tumor? This feeling made me feel like "there is only one truth!", which suddenly felt like a detective who solved the case.
"Boldly imagine, be careful to verify!" We were also excited and quickly made a batch of immunohistochemical markers according to the idea of intracranial germ cell tumors.Because the immunohistochemistry test requires a certain reaction time, in the next two days, everyone was thinking about this case while working hard, looking forward to the confirmation of the results. Finally, it was time to get the tablets for immunohistochemistry. After repeatedly observing the results of immunohistochemistry , Professor Wang Chaofu made the final decision - it was intracranial germ cell tumor!
This exciting moment of witnessing the answer to the mystery is really happier than winning the lottery for me who just left the "rookie" camp. On the one hand, we are happy for us to solve the case, and on the other hand, we are happy for Hyosung, because this tumor has a way to treat it and has a good prognosis. The 10-year survival rate exceeds 90%, Hyosung is saved!
We immediately called Xiaoxing and told her that the lesion was not only diagnosed, but also told her that the treatment effect would be very good. She cried with joy on the other end of the phone. After the diagnosis, Xiaoxing was treated according to this disease. She has received 9 courses of radiotherapy. All her health is in good condition. We sincerely wish this lucky girl that she will be healthy and safe in the future. Xiaoxing said that meeting Director Wang Chaofu is her greatest luck. She will never forget the sentence when she first met Director Wang, "Don't be afraid, little girl, we will definitely help you diagnose it clearly. Believe us, there is a rescue!"
Xiaoxing's story ends here. Every time I think of this case, I find it difficult to calm down in my heart for a long time. A few days ago, during the consultation, we talked about this case again. Teacher Wang told us earnestly: Patients always hope to have a clear result when they go to the hospital for treatment. Pathological diagnosis is like a pointing card at the intersection during the diagnosis and treatment of a disease. Every pathological diagnosis is related to the fate of the patient. You must constantly improve your diagnosis level. When encountering atypical cases, you must not only make bold assumptions based on your knowledge and experience, but also carefully follow evidence and seize clues to solve the case step by step.
People often say that pathology is the "terminator" of disease diagnosis. The vivid cases have made me feel the kind of responsibility that "one-time hit" and "one word of money" are shouldered. I hope that like Teacher Wang, I will continue to make progress, not only have superb diagnostic skills, but also have strong spiritual strength, and continue to walk firmly and steadily on this "wire" road. Written by
Article丨Wang Pathology Department King Xue
Edited by 丨Wen Zhaoqi
