Tokyo Women's Medical University

School of Medicine

Surgical Pathology

Overview

The Department of Surgical Pathology contributes to medical care by being in charge of final diagnosis of diseases through histopathological and cytological procedures.

① Histopathological diagnosis: Biopsy tissue diagnosis, tissue diagnosis of surgical specimens, and rapid diagnosis for specimens taken during surgery are performed.
1) Biopsy: The department performs final diagnosis of diseases by microscopic observation of tissue specimens taken from lesions. All organs, including the gastrointestinal tract, lungs, liver, kidneys, and skin, are targeted.
2) Surgical specimen tissue diagnosis: This is performed on organs that have been surgically removed. In the case of cancer (malignant tumor), its spread, histological type, presence or absence of marginal lesions, and presence or absence of venous or lymphatic invasion are determined. This determines the curative potential of the surgery and provides important information for determining the postoperative treatment plan.
3) Intraoperative Rapid Diagnosis: A specimen is prepared from tissue collected during surgery (the main body of the lesion, lymph nodes suspected of metastasis, or resected margins), and a histopathological diagnosis is made in a short period of time. This provides important information for determining the surgical procedure by diagnosing whether the lesion is good or bad and whether it extends to the margins.
In addition, we verify whether the target molecules of molecular targeted therapy are expressed in each tumor case (e.g., female hormone receptors and Her2 in breast cancer, c-kit in gastrointestinal stromal tumors) by immunohistochemical staining and other methods, contributing to the practice of personalized medicine (companion diagnosis). Recently, we are also cooperating in cancer genome medicine using paraffin blocks stored in our department as material.
*Cancer genome medicine: Comprehensive analysis of genetic abnormalities in cancer cells to select and implement treatments that are expected to be effective. For details, please refer to the page of the Department of Clinical Genomics.

② Cytology: In cytology, cells are collected from the lesion and we observe them, determine whether the lesion is benign or malignant, and, if malignant, provide a diagnostic report to the clinical departments on the presumed tissue type, thereby contributing to the determination of treatment strategy. Cytology is broadly classified into exfoliative cytology and puncture cytology, depending on the method used to collect the specimen. The former includes specimens from urine, sputum, body fluid, and the cervix, while the latter includes specimens from the thyroid gland, mammary gland, and lymph nodes.

Thus, the Department of Surgical Pathology plays an important role in the final diagnosis of diseases and in determining the course of treatment. Our department is staffed by pathologists specializing in various diseases of various organs full-time and concurrently, and we strive to meet the needs of all clinical departments and patients, and to select the most appropriate treatment.

Education Details

Pre-Medical Education

　　　

Segment	Grade	Subject	Person in charge
Segment 4	2nd year	Clinical Diagnosis: Specimen Testing	Lecture Yoji Nagashima
Segment 4	2nd year	Pathology of respiratory organs	Lecture Yoji Nagashima 　　　 Saeko Yoshizawa
	2nd year	Pathology of respiratory organs	Practice Staff
Segment 4	2nd year	Pathology of urinary and male genital organs	Lecture Yoji Nagashima 　　　 Sekiko Taneda
	2nd year	Pathology of urinary and male genital organs	Practice Staff
Segment 5	3rd year	Pathology of gastrointestinal tract	Lecture Yoji Nagashima
	3rd year	Pathology of gastrointestinal tract	Practice Staff
Segment 5	3rd year	Pathology of hepatobiliary system and pancreas	Lecture Yoji Nagashima
	3rd year	Pathology of hepatobiliary system and pancreas	Practice Staff
Segment 6	3rd year	Pathology of musculoskeletal system	Lecture Tomoko Yamamoto
	3rd year	Pathology of musculoskeletal system	Practice Staff
Segment 7	4th year	Pathology of collagen disease	Lecture Yoji Nagashima
Segment 8	4th year	Basic training in the diagnostic pathology ward	Practical training Yoji Nagashima
	4th year	CPC	Practice Staff
Segment 9	5th year	Hospital practice	Practice Yoji Nagashima
	6th year	Clinical clerkship	Practice Staff
Segment 10	6th year	Specimen Testing II	Lecture Yoji Nagashima
Segment 6	3rd year	Pathology of musculoskeletal system	Lecture Tomoko Yamamoto
Segment 6	3rd year	Pathology of musculoskeletal system	Lecture Tomoko Yamamoto

Initial-stage Resident　

We conduct teaching the preparation of CPC reports and the entire school CPC. If students choose the Department of Pathology, we instruct them to understand the fundamentals of histopathology and the morphology and pathophysiology of diseases in general through the sectioning of surgical tissue specimens, tissue diagnosis, and cell diagnosis. If they experience instructive cases, they are encouraged to make presentations at the annual meeting of the Japanese Society of Pathology (residents' poster, awarded the best presentation award once) and at the residents’ reporting meeting of the Women's Medical Association (awarded the best presentation award twice).

Pathology specialist　

In cooperation with the Department of Pathology, affiliated medical facilities (Higashi Medical Center, Yachiyo Medical Center), and cooperating facilities (Yokohama City University Hospital, St. Luke's International Hospital, Cancer Institute Hospital, National Center for Child Health and Development, Tokyo Metropolitan Neurological Hospital, etc.), pathologists are taught to obtain a board certification in three years, as well as board certification as a cytology specialist and molecular pathology specialist. (Application for renewal of the pathology training program at Tokyo Women's Medical University is pending). We also encourage students them to publish papers and present at academic conferences with a view to obtaining a degree.

Medical Staff Development　

We strive to develop the careers of our clinical technologists and cytologists. We encourage presentations and papers at the Society of Clinical Cytology. (The pathology laboratory is certified as ISO 15189 compliant.)

Research Details

1. Tumor cell biology: The mechanisms by which cancer invasion, metastasis, and polarity abnormalities occur are investigated using immunohistochemical and cell biological techniques.
2. Clinicopathological study of renal tumors: The frequency of tumors arising in the kidney is not necessarily high, but they have unique characteristics, such as complications with familial tumor syndromes, and a variety of histologic types. We conduct clinicopathological studies of renal tumors in cooperation with many medical institutions.
3. Research on neuromuscular diseases: We are analyzing central nervous system lesions in Fukuyama muscular dystrophy and investigating the causative gene, fukutin, and analysis of morphological and molecular pathological studies of neurodegenerative diseases.
4. Research on cardiovascular diseases: We are studying the pathogenesis of cardiomyopathy and pathogenesis of myocardial lesions, and conducting histopathological, immunohistological, and molecular biological studies using experimental animals, biopsy specimens of myocardium, and autopsy specimens.
5. Collaborative Research with Clinical Departments

Faculty

Yoji Nagashima
Tomoko Yamamoto
Sekiko Taneda
Saeko Yoshizawa
Atsuko Seki
Naoko Ito

Related links

Research Achievements Database

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