2016年 · 第45卷第11期

For a long time, central nervous system (CNS) tumors have been classified mainly based on their histogenesis^[1,2]。 In recent 20 years, it has been found that some CNS tumors with the same histological manifestations have obvious molecular genetic differences. With the continuous discovery of new molecular markers, they are gradually becoming the basis for accurate classification of CNS tumors^[3]。 1-3 May 2014 International Society of Neuropathology reaches Harlem consensus and guidance in the Netherlands^[4]On June 22-24, 2015, the WHO CNS Tumor Classification Committee held a meeting in Heidelberg, Germany, and determined the revised plan for the 4th edition of the WHO CNS Tumor Classification (hereinafter referred to as the 2016 revised version), which was officially published in May 2016^[5]。 The 2016 revision reflects the new progress in CNS tumor pathology and molecular pathology since the 4th edition of the WHO classification was published in 2007.

Human papillomavirus (HPV) infection has been regarded as the main pathogenic factor of cervical cancer for a long time, and the oncogenes E6 and E7 play a key role. However, about 10% of cervical adenocarcinomas and a certain percentage of cervical squamous cell carcinomas test negative for HPV^[1]。 We investigated the expression and significance of p16, p53 and hTERC in HPV-negative cervical squamous cell carcinoma by detecting HPV DNA, E6/E7 mRNA, p16, p53 and hTERC.

superfical cervicalvaginal myofibroblastoma (SCVM) is a benign mesenchymal tumor that occurs in the superficial stroma of the female vagina and cervix submucosa. We retrospectively analyzed the clinical data of 6 cases of SCVM in order to deepen the understanding of the disease by clinical and pathologists.

The patient was a 48-year-old male. There was headache for 4 months without obvious trigger, which was pulsatile pain in the right temporal roof, accompanied by swelling and pain in the right orbit in severe cases, and the pain was slightly relieved after taking analgesics. MRI examination of the head in the outpatient clinic showed that the right top meninges were obviously thickened. Considering the possibility of inflammatory hyperplasia, please follow up to exclude the tumor (Figure 1)。 The patient was admitted to the Department of Neurology of our hospital on April 3, 2013 to complete relevant examinations: routine cerebrospinal fluid, cerebrospinal fluid virus screening, cerebrospinal fluid cryptococcal smear, meningococcal smear, bacterial and fungal smear and various biochemical examinations showed no abnormal changes, but serum IgG4 and IgG levels were not checked. There were no other changes in discomfort. Measures such as lowering intracranial pressure and neurotrophic therapy were taken for the patient, but the headache symptoms of the patient persisted and did not improve significantly. Then the patient was transferred to the neurosurgery department, and the meningioma was clinically resected.

The patient was a 63-year-old female. He was admitted to hospital on June 29, 2015 due to "intermittent dizziness for 1 and a half years, melena for 1 month and aggravation for 2 weeks". External gastroscopy revealed tumor at the junction of gastric antrum and biopsy pathology revealed poorly differentiated adenocarcinoma. PET-CT showed localized thickening of gastric antrum, which did not rule out the possibility of gastric cancer. 15 years after previous ovarian cyst surgery, 30 years with chronic hepatitis B, and 3 years with a history of hypertension. Specialist physical examination: mild tenderness in the upper abdomen, Yu negative. "Radical gastric cancer surgery" was performed, and the specimens were sent to pathology.

The patient was a 25-year-old female. He was admitted to the hospital on August 13, 2015 because he accidentally found space-occupying lesions in his left kidney for 1 day after physical examination in another hospital. CT examination in other hospitals showed that a slightly low-density shadow mass was seen at the lower pole of the left kidney, with a clear boundary, about 3.8 cm ×3.6 cm in size, and the tumor was unevenly enhanced after enhancement. B-ultrasound in our hospital showed an uneven hyperechoic mass at the lower pole of the left kidney, about 4.1 cm ×4.0 cm ×3.6 cm in size, partially protruding outward with clear boundaries, uneven internal echoes, a dark area with a range of about 1.6 mm ×1.5 mm, dotted and striped blood flow signals, and no separation in the collective system. Color Doppler flow imaging (CDFI) showed no obvious abnormalities in the blood flow of both kidneys. There was no abnormality in physical examination, and laparoscopic partial nephrectomy was performed clinically in our hospital for "left kidney tumor".

The patient was a 49-year-old male. He was admitted to hospital on February 1, 2016 due to blood in his nose for 1 year and aggravation with nasal congestion for 2 months. There was no deformity of the nose in vitro after admission, no inflammation of the nasal wing, slight congestion of the nasal mucosa, and no obvious deviation of the nasal septum. MRI of nasopharynx in our hospital showed a round-like abnormal signal in the posterior parietal wall of nasopharynx and behind nasal septum, with a size of about 2.0 cm ×1.5 cm ×1.2 cm. T1WI showed isosignal, T2WI showed isosignal and slightly higher signal, and the enhancement scan did not enhance. A rhinoscopy revealed a new organism in the posterior part of the nasal septum, and a biopsy was taken. The pathological diagnosis of biopsy was "consistent with well-differentiated papillary adenocarcinoma". After thyroid ultrasonography, several scattered hypoechoes were found in both thyroid lobes, the larger one was about 2.3 cm ×1.5 cm, and the boundary was not clear, suggesting that thyroid cancer was not excluded. Intraoperative thyroid frozen section was diagnosed as "papillary thyroid carcinoma", and nasopharyngeal mass resection, radical thyroidectomy and bilateral central lymph node dissection were performed, and the tissue was removed and sent to pathology.

The patient was a 27-year-old female. Pregnancy 4 delivered 0, due to "37 weeks of pregnancy^＋4The patient was admitted to the hospital with "threatened labor". The patient had a smooth pregnancy, low-risk screening for Down syndrome, no fetal abnormalities in B-ultrasound of abnormality examination, and normal oral glucose tolerance test. At 8 pm on March 13, 2015, she was admitted to the obstetrics department of China-Japan Friendship Hospital for half a day due to lower abdominal pain. At admission, the cervix resolved by 70%, and the cervix volume was one finger, soft, and centered, S-3. After admission, fetal heart rate monitoring showed a reactive type, with uterine contractions of 30 s/ (3~5) min. After the uterine cervix was opened 2 cm, he entered the delivery room, and the fetal heart rate was monitored. The uterine contractions were regular and the fetal heart rate was responsive. The fetal heart rate was normal every 30 min after auscultation. At 3: 50 a.m. on March 14th, the patient complained of defecation, and the uterine cervix was fully opened. At this time, the fetal head had been exposed, went to the delivery bed, and the auscultation did not reach the fetal heart. At 3: 55 am, the water broke naturally and the amniotic fluid was clear. The newborn was delivered at 4:4 a.m. under episiotomy with severe blood loss appearance, no signs of life, Apgar score 0. The posterior amniotic fluid was bloody and the amount was about 400 mL. At 4: 10 am, the placenta and fetal membranes were delivered naturally. There was a blood vessel rupture at the junction between the root of the umbilical cord and the placenta, which was longitudinal and about 0.5 cm long, and there was still blood oozing from the rupture. The newborn still has no signs of life after rescue. Placenta and umbilical cord send pathology.

The patient was a 41-year-old female. Physical examination found that the left ovarian mass was 2 years old, and its growth has accelerated recently. On September 11, 2014, I went to Shengli Oilfield Central Hospital. The patient found a left ovarian mass during physical examination in September 2012, and was reviewed regularly without special treatment. Since March 2014, symptoms such as frequent urination and urgency have appeared. B-ultrasound examination showed that the tumor was significantly enlarged, with calcification in the center, and the boundary was still clear. There were no abnormalities in the laboratory tests, abdominal and pelvic CT examinations showed no abnormalities in liver and kidney scans, good bladder filling, normal uterine size and position, and a type of round mixed density focus in the left adnexal area (Figure 1), with an area of 10.1 cm ×8.7 cm, smooth edge, CT value of about 16~28 HU, multiple plaque-like calcifications were seen in it, and no enlarged lymph nodes were seen in the retroperitoneal and pelvic cavities. CT diagnosis: mixed density focus in the left adnexal area, considering the possibility of teratoma. During the operation, a hard mass was seen in the left ovary, about 10.0 cm ×8.0 cm in size, protruding from the ovarian surface, with a smooth surface and no adhesion to the surrounding tissues. The tumor and left adnexus were completely resected and sent to rapid pathological diagnosis. The result was left ovarian malignant tumor, the morphology was consistent with chondrosarcoma. Clinically, total hysterectomy and right adnexal were performed and pelvic lymph node dissection was performed.

Biological samples are important resources for medical research. Pathological tissue and cell samples are common clinical biological samples, which mainly come from clinical surgery, biopsy, puncture and other operations. They can be used for pathological diagnosis and medical research by preparing sections, smears and extracting biological macromolecules. Sample is the foundation of medical research, and its quality determines the accuracy and reliability of research results to a large extent. With the rapid progress of genomics, transcriptomics and proteomics, various analytical techniques have put forward higher requirements on the quality of biological samples^[1,2]。

Breast cancer is a highly heterogeneous tumor, with significant diversity in genetics and gene phenotype. These differences are manifested in the proliferation rate, invasive ability, metastatic potential, therapeutic effect and pathogenic mutation of tumor cells. What is the genetic basis for breast cancer heterogeneity? What is its source? The structural composition of breast diversity may be the basis of breast cancer heterogeneity. Combined with the use of high-throughput sequencing technology, it will help people to study the origin of breast cancer cells, and then explain the occurrence and development process of breast cancer. From the perspective of normal breast epithelial diversity, we summarize the research progress on the origin, genetic nature and related treatment and prognosis of breast cancer heterogeneity.

The image information of pathological slides is digitized by full-slide digital scanning technology, forming digital slices, which marks the emergence of digital pathology. On March 6, 2016, the "First China Digital Pathology Summit", sponsored by the Pathology Branch of Chinese Medical Association and the Cancer Pathology Professional Committee of Chinese Anti-Cancer Association, and hosted by the Pathology Research Laboratory of West China Hospital of Sichuan University, was held in Chengdu. On August 28th, during the 8th seminar on pathological diagnosis of breast diseases held in Suzhou, a special seminar on digital pathology was held again. Professor Bian Xiuwu, Professor Ding Huaye, Professor Ding Yanqing and other famous national pathologists attended the meeting. Eight domestic and foreign digital pathology equipment manufacturers and representatives of "91360" and other operating enterprises also attended the meeting. The conference focused on six themes: "Development field and direction of digital pathology technology; Legal issues and information standardization of digital pathology; Operation mode of digital pathology application; How to promote the rapid development of digital pathology; Difficulties and problems of digital pathology application".

In recent ten years, with the rapid development of computer, digital, information, network and other related technologies, microscopic digital interactive system, digital slice network teaching and three-dimensional gross specimen have been widely used in pathology experiment teaching. Traditional pathology experiment teaching is gradually transforming into a brand-new pathology experiment teaching mode-digital networked pathology experiment teaching. The brand-new teaching mode has injected new elements in all aspects such as pre-class preparation, classroom teaching, teacher-student interaction, after-class review, homework form, examination mode, etc., which greatly improves teaching efficiency and teaching quality. Zhejiang University carried out the teaching reform of digital pathology experiment earlier in China^[1,2]After many years of reform, innovation and perfection, we have accumulated rich experience in digital experimental teaching. We talk about the reform and application of experimental report in digital networked pathology experimental teaching for many years.