课程介绍 Course Introduction
学分：4 | 先修课：生理学、微生物学 | 学期：第五学期
本课程研究疾病的发生发展规律，分为总论和各论两部分。总论包括细胞和组织的适应与损伤、损伤的修复、局部血液循环障碍、炎症、肿瘤等基本病理过程。各论介绍各系统常见疾病的病因、发病机制、病理变化和临床病理联系。课程通过理论讲授和病理切片观察，培养学生认识和分析疾病的能力。
This course studies the mechanisms and patterns of disease, divided into general and systemic pathology. General pathology covers cellular adaptation and injury, tissue repair, local hemodynamic disorders, inflammation, and neoplasia. Systemic pathology introduces etiology, pathogenesis, pathological changes, and clinicopathological correlations of common diseases in each organ system.
Steps
Step 1
Disease System Selection and Pathology Slide Collection
The core task of this step is to select an important disease system and collect relevant pathological slide materials and clinical information. Choose diseases with typical pathological features from various systems to ensure sufficient morphological changes for observation and analysis. Pathology is the bridge between basic and clinical medicine, and pathological diagnosis is the "gold standard" of disease diagnosis.
• Select one system from cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, nervous systems, etc.; identify 2-3 typical diseases (e.g., hypertensive heart disease, lobar pneumonia, gastric ulcer, glomerulonephritis, breast cancer)
• Collect pathology materials: gather gross specimen photos, H&E stained tissue slide images, special stains (immunohistochemistry, PAS, Masson's trichrome), and corresponding clinical history data
• Study normal histology of each organ as control; review etiology, pathogenesis, and clinicopathological correlation of related diseases
Deliverable: Pathology material collection (normal tissue control, lesion tissue images, clinical data), disease selection rationale report | Quality standard: Typical disease selection, clear and complete image materials, comprehensive clinical information
Step 2
Basic Pathological Changes Observation and Identification
The core task of this step is to observe and identify various basic pathological changes, including degeneration, necrosis, apoptosis, inflammation, repair, and tumors. Basic pathological changes are the common morphological foundation of all diseases. Accurate identification of basic lesions is fundamental to pathological diagnosis. Requires careful observation of cellular and tissue morphological changes under microscope or digital slides.
• Cell and tissue adaptation and injury: observe morphological features of atrophy, hypertrophy, hyperplasia, metaplasia; identify various degenerations (cellular swelling, fatty change, hyaline change, amyloidosis) and necrosis types (coagulative, liquefactive, fibrinoid, gangrene)
• Injury repair: observe composition and morphological features of granulation tissue; identify scar tissue; understand basic process of wound healing
• Inflammation: observe basic pathological changes of acute inflammation (alteration, exudation, proliferation); identify various inflammatory cells (neutrophils, lymphocytes, macrophages, plasma cells, eosinophils); compare characteristics of serous, fibrinous, purulent, and hemorrhagic inflammation
Deliverable: Basic pathological changes observation report (lesion descriptions, morphological features, differential key points, typical images) | Quality standard: Accurate lesion identification, professional and standard morphology description, clear differential points
Step 3
Systemic Disease Pathomorphology Observation and Description
The core task of this step is to systematically observe pathomorphological changes of selected diseases and perform standardized morphological description. Observe lesions at both gross specimen and histological levels; describe location, number, size, shape, color, texture, and relationship with surrounding tissues. Standardized pathological description is the foundation of pathological diagnosis.
• Gross specimen observation: describe lesion location, extent, size (with specific dimensions like cm×cm×cm), shape, color, texture, borders, relationship with surrounding tissues; draw gross schematic diagrams or take photographs
• Histological observation: observe overall structure and distribution characteristics at low power; observe cellular morphological details at high power (cell size, shape, arrangement, nuclear features, mitotic figures); record stromal reaction and infiltration
• Pathological description writing: write lesion descriptions following pathology standards, including gross and microscopic sections; use professional terminology; describe observed lesions objectively and accurately
Deliverable: Systemic disease pathology observation report (gross description, microscopic description, pathological images, schematic diagrams) | Quality standard: Comprehensive and careful observation, standard and accurate description, correct professional terminology
Step 4
Pathological Diagnosis and Differential Diagnosis Analysis
The core task of this step is to make pathological diagnosis based on pathomorphological observation results combined with clinical data, and perform differential diagnosis analysis. Pathological diagnosis requires comprehensive analysis of morphological features, immunophenotype, molecular testing, and clinical information to exclude similar diseases. Differential diagnosis demonstrates pathologists' clinical thinking ability and professional level.
• Pathological diagnosis: make preliminary pathological diagnosis based on morphological features (tissue architecture pattern, cell morphology, invasion pattern); determine disease type, grade, and stage
• Differential diagnosis: list 2-3 diseases needing differentiation; analyze morphological similarities and differences; propose further examination methods (special stains, immunohistochemistry, molecular testing) for definitive diagnosis
• Clinicopathological correlation: discuss relationship between pathological changes and clinical manifestations; explain pathological basis of patient symptoms, signs, and laboratory results; analyze disease outcome and prognosis
Deliverable: Pathological diagnosis analysis report (pathological diagnosis, diagnostic criteria, differential diagnosis table, clinicopathological correlation) | Quality standard: Accurate and evidence-based diagnosis, clear differential diagnosis thinking, strong clinicopathological correlation
Step 5
Pathology Report Writing and Case Discussion
The core task of this step is to write a standardized pathological diagnosis report and organize case discussion. Pathology report is the most important medical document in pathology department with legal effect, requiring standardized format, accurate diagnosis, and objective description. Case discussion develops clinical thinking ability and improves problem-solving skills.
• Write pathological diagnosis report: follow clinical pathology report standard format, including patient information, specimen information, gross examination, microscopic examination, pathological diagnosis, remarks (IHC results, special stains, molecular testing)
• Create illustrated pathology report: select typical gross and microscopic images; label key lesion features; produce well-illustrated pathology report with both images and text
• Case discussion: organize case discussion; present case features, diagnostic thinking, differential diagnosis key points; discuss etiology, pathogenesis, latest research progress, and treatment principles
Deliverable: Standard pathological diagnosis report (PDF format with gross description, microscopic description, pathology images, diagnostic conclusion), case discussion PPT | Quality standard: Standard report format, accurate diagnosis, well-illustrated, in-depth and insightful case discussion