临床病理交流.ppt
http://www.100md.com
参见附件(582KB)。
Patients-Diseases
Surgeons
Pathologists
现 状
Present situation
A COMMUNICATION GAP EXIST BETWEEN PATHOLOGISTS AND SURGEONS
Powsner SM et al. Arch Pathol Lab Med 2000; 124:1040
病理医师和外科医师的交流
存 在 差 距
Clinicians Mars and Pathologists Venus
Clinician Interpretation of Pathology Reports
Powsner SM et al Arch Pathol Lab Med 2000; 124:1040-1046
临床医师来自火星
病理医师来自金星
THE ART OF COMMUNICATION BETWEEN PATHOLOGISTS AND THEIR CLINICAL COLLEAGUES
病理医师和临床医师
交流方法艺术
Clinician Interpretation of Pathology Reports
Confusion or Comprehension
Ruby SG. Arch Pathol Lab Med 2000; 124:943-944
临床医师解释病理报告
混 淆 or 理 解
Many of our clinical colleagues often need to be remined of this fact; even simple information concerning age, sex or location may be missing on the request form...请求单上甚至漏写
有关性别，年龄和部位等简单的信息
To diagnose a tumor in the absence of clear and complete clinical data is foolhardy, dangerous and sometimes impossible
缺乏清楚而完整的临床资料
诊断肿瘤
莽撞，危险，有时不可能
"I can see only what is in the tissues you gave me"
我只能看到你给我的组织
如果没有临床资料
In no area of surgical pathology does the pathologist play a more important and crucial role than in the diagnosis of tumors
病 理 学 家
肿 瘤 诊 断
决定性的作用
The patient or lay person often is entirely ignoraqnt of this role and fondly imagines that their surgeon, other clinician or oncologist is the true diagnostician
病人并不了解这种作用
天真地认为...
Limitations of Histologic Diagnosis
组织学诊断
局限性
培 训
Train personnel
全科病理医师GENERAL
专科病理医师SPECIAL
UNIVERSITY HOSPITAL
Clearly, surgical pathology evolved in response to the needs of surgeons.
很明显，外科病理学是应外科医师的需求而发展起来的
病理学会诊
Pathologic consultation
The difficult diagnosis in surgical pathology
病理诊断困难
Some questions remain unanswered after extensive textbook review, either because the lesion in question is not covered in the text or because its presentation is atypical.
THE DIFFICULT DIAGNSIS IN SURGICAL PATHOLOGY
病理诊断困难
We all occasionally encounter surgical pathology cases that pose significant diagnostic difficulty.These are resolved either by CONSULTING a textbook or one's colleagues or sending the case out in consultation.
The appearance is consistent with ..., but ... cannot be ruled out because of the material insufficient for evaluation
病变符合 ...
不能除外 ...
冰冻切片
Frozen sections
The frequency of false positive diagnosis is inversely related to that of deferred diagnosis, so the attempt to FORCE a diagnosis in a difficult situation is likely to lead to the feared result of a false positive interpretation
强行作出(冰冻)诊断
可能导致可怕的假阳性结果
Most false negative interpretations are probably due to sampling error and are thus unavoidable
多数假阴性结果
取材不当所致
不可避免
When one or two sections are taken from a 10 cm specimen, we will invariably encounter situations in which the definitive diagnosis is not made until many more sections are examined the following day
一个10cm的标本 一或两张5μ冰冻切片
检查多数(石蜡)切片之后
才能作出最后诊断
The definitive diagnosis will have to wait for the permanent H&E sections
最后诊断
必须等待石蜡切片
There Are No Guarantees in This Life
(with the exceptions of death and taxes)
世间没有绝对保证
死亡和纳税例外
'BENIGN'
The need for timely, accurate and detailed reports has never been greater, especially in our increasingly subspecialized and litigious society
要求及时，准确而详尽的报告...爱打官司的社会
PATHOLOGISTS ARE PHYSICIANS AND HUMAN BEINGS
病理医师是医师,也是人
Patients-Diseases
Surgeons
Pathologists
现 状
Present situation
A COMMUNICATION GAP EXIST BETWEEN PATHOLOGISTS AND SURGEONS
Powsner SM et al. Arch Pathol Lab Med 2000; 124:1040
病理医师和外科医师的交流
存 在 差 距
Clinicians Mars and Pathologists Venus
Clinician Interpretation of Pathology Reports
Powsner SM et al Arch Pathol Lab Med 2000; 124:1040-1046
临床医师来自火星
病理医师来自金星
THE ART OF COMMUNICATION BETWEEN PATHOLOGISTS AND THEIR CLINICAL COLLEAGUES
病理医师和临床医师
交流方法艺术
Clinician Interpretation of Pathology Reports
Confusion or Comprehension
Ruby SG. Arch Pathol Lab Med 2000; 124:943-944
临床医师解释病理报告
混 淆 or 理 解
Many of our clinical colleagues often need to be remined of this fact; even simple information concerning age, sex or location may be missing on the request form...请求单上甚至漏写
有关性别，年龄和部位等简单的信息
To diagnose a tumor in the absence of clear and complete clinical data is foolhardy, dangerous and sometimes impossible
缺乏清楚而完整的临床资料
诊断肿瘤
莽撞，危险，有时不可能
"I can see only what is in the tissues you gave me"
我只能看到你给我的组织
如果没有临床资料
In no area of surgical pathology does the pathologist play a more important and crucial role than in the diagnosis of tumors
病 理 学 家
肿 瘤 诊 断
决定性的作用
The patient or lay person often is entirely ignoraqnt of this role and fondly imagines that their surgeon, other clinician or oncologist is the true diagnostician
病人并不了解这种作用
天真地认为...
Limitations of Histologic Diagnosis
组织学诊断
局限性
培 训
Train personnel
全科病理医师GENERAL
专科病理医师SPECIAL
UNIVERSITY HOSPITAL
Clearly, surgical pathology evolved in response to the needs of surgeons.
很明显，外科病理学是应外科医师的需求而发展起来的
病理学会诊
Pathologic consultation
The difficult diagnosis in surgical pathology
病理诊断困难
Some questions remain unanswered after extensive textbook review, either because the lesion in question is not covered in the text or because its presentation is atypical.
THE DIFFICULT DIAGNSIS IN SURGICAL PATHOLOGY
病理诊断困难
We all occasionally encounter surgical pathology cases that pose significant diagnostic difficulty.These are resolved either by CONSULTING a textbook or one's colleagues or sending the case out in consultation.
The appearance is consistent with ..., but ... cannot be ruled out because of the material insufficient for evaluation
病变符合 ...
不能除外 ...
冰冻切片
Frozen sections
The frequency of false positive diagnosis is inversely related to that of deferred diagnosis, so the attempt to FORCE a diagnosis in a difficult situation is likely to lead to the feared result of a false positive interpretation
强行作出(冰冻)诊断
可能导致可怕的假阳性结果
Most false negative interpretations are probably due to sampling error and are thus unavoidable
多数假阴性结果
取材不当所致
不可避免
When one or two sections are taken from a 10 cm specimen, we will invariably encounter situations in which the definitive diagnosis is not made until many more sections are examined the following day
一个10cm的标本 一或两张5μ冰冻切片
检查多数(石蜡)切片之后
才能作出最后诊断
The definitive diagnosis will have to wait for the permanent H&E sections
最后诊断
必须等待石蜡切片
There Are No Guarantees in This Life
(with the exceptions of death and taxes)
世间没有绝对保证
死亡和纳税例外
'BENIGN'
The need for timely, accurate and detailed reports has never been greater, especially in our increasingly subspecialized and litigious society
要求及时，准确而详尽的报告...爱打官司的社会
PATHOLOGISTS ARE PHYSICIANS AND HUMAN BEINGS
病理医师是医师,也是人
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