Книги / Essentials_of_Anatomic_Pathology

2nd edn. Edited by Liang Cheng and David G. Bostwick. Humana Press, Totowa, NJ, USA, 2005. Hard cover: ISBN 1-588-29-460-9, $225; paperback: ISBN 1-588-29-461-7, $150.

For a physician training or practising in histopathology (or anatomic pathology in the US) a good general text to which most problems generated by the daily reporting workload can be referred is essential. This role is filled, admirably so for most of us, by some of the monoliths of the subject, the best known of which is probably Rosai and Ackerman’s Surgical Pathology; a copy this weighty tome must, I would think, reside in almost every reporting room in the world. It is such a role that the recently published second edition of Essentials of Anatomic Pathology also aims to fill, in the words of its preface ‘an up-to-date handbook that contains relevant information to establish an accurate diagnosis’ which is ‘organised to allow easy reference for daily practice’.

A glance at the chapter headings immediately makes clear the strength of this book, which is its great breadth of coverage. As well as chapters covering pathology of all the organ systems as one would expect, there are chapters covering all of the ‘fringe’ specialities with which most general pathologists will come into contact only occasionally; so, we have chapters on diagnostic molecular pathology, human genetic disorders, forensic pathology, electron microscopy, microbiology and transplantation pathology. I know of no other general text which covers these in any depth; usually, when these topics arise, one has the daunting task of winnowing a desired nugget of information from the mass of detail found in the larger, specialist volumes. Presenting all of this information in one place at a level appropriate to the practising pathologist is, therefore, an extremely worthwhile goal.

A closer look at the chapters themselves is, however, somewhat disappointing. The format throughout the book is based on subject headings and bullet points with little continuous prose to be found; presumably, this was done to condense as much information as possible into a limited space, but it has the effect of rendering coherent reading through a particular topic

almost impossible, so that the book is likely to be of much less use for learning and study than as a reference, although it may be of some use as a checklist or aidememoire in exam revision. There are also rather frequent typographical errors appearing both in text and in figure legends throughout, which does not help matters. Format aside, however, the overarching problem with this book is the dreadful quality of the photographs, which are grainy, black and white and almost universally too small. The relentless monochromasia is at the very least unhelpful in a discipline in which chromatic staining characteristics are often an important diagnostic feature; the superimposed poor quality renders many of the pictures quite useless. In particular, chapter 7 eloquently demonstrates why the most successful publications in cytopathology have been pictorial atlases; more than any other, this subject depends on recognizing patterns and subtle subcellular features that it can be almost impossible to appreciate from a description alone. Here however one is expected to do just that as the dark smudges that comprise figures 71– 142 do not allow even basic nuclear characteristics to be recognized; in some cases, the nuclei themselves cannot even be seen. In addition, these figures are presented separate from the text at the end of the chapter, so that it is always necessary to hold two pages open at once; a small point, but irritating nonetheless.

The dire standard of the figures is, unfortunately, consistent throughout the book. In many ways this is a shame as the level of information offered by the text is, if you can manage the bullet points, mostly very good and it is logically organized, with indices which work well. Chapter 8 on neuropathology is a particularly fine example which gives excellent coverage of central nervous system (CNS) tumours with clinical features, imaging appearances, intraoperative smear and histological appearances, and differential diagnoses listed for each entity. This chapter is backed up by a strong reference section, and even includes brief descriptions of neurodegenerative diseases, metabolic disorders affecting the CNS and so on; the only serious omission is adequate figures to accompany the descriptions. Similarly, chapter 9 on lymph node pathology is thorough

656 Book review

and gives a full set of facts for each disease, including morphology, detailed immunophenotype, differential diagnoses and genetics. The remaining chapters complete coverage of all of the organ systems and, although many are less successful than these two, all offer at least core information on all of the entities one is ever likely to see. Perhaps unsurprisingly, the best tend to be those with the most restricted scope; chapter 17, for instance, devoted entirely to tumours of the salivary glands, offers plenty of detail along with features such as various tables comparing characteristics of the tumours, very useful in differential diagnosis. Chapters such as those dealing with gynaecological and gastrointestinal pathology are weaker, offering less information about a wider range of subjects; aetiological factors, for instance, notably Helicobacter pylori in the chapter on oesophagus and stomach, often receive passing mention only. International Federation of Obstetrics and Gynoecology (FIGO) staging and TNM classification criteria are, however,

included for most major tumour types, which is a helpful feature.

Overall, Essentials of Anatomic Pathology is a thorough book which offers a remarkably complete account of most areas of the subject, albeit in a format that may not be to everyone’s taste. It is unfortunate that the inadequate figures are such an overwhelming weakness that one would find it hard to recommend this book above one of the much better illustrated pathology texts on the market. Having said that, I believe this book would still be a welcome addition to the reporting room library for its extremely valuable non-specialist coverage of those areas, such as electron microscopy and microbiology, which all of us encounter on occasion and which lie outside the scope of most general texts.

Alexander Jeans

Specialist Registrar in Cellular Pathology,

Radcliffe Infirmary, Oxford, UK

ajeans@doctors.org.uk