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Bone Marrow Biopsies Revisited—A New Dimension for Hematological Malignancies
680
BOOK R E V I E W S
confusing to the average medical student. This is not a book which could easily meet all the requirements of an undergraduate in the average current style curriculum and could not be recommended as a set text. Nevertheless because it represents a first class collection of excellent colour photographs of gross pathology, some examples of which are quite I-are, it should be an acquisition of every medical library.
EM study alone and there are a number of other statements that could confuse or mislead the trainee. All in all, the book fulfils its small print I found it stimulating and title-“a self evaluation manual”-and rewarding as a quick revision of “spot diagnoses ”. But it provides neither a reliable guide nor an introduction to “diagnostic ultrastructural pathology” and cannot be recommended to the novice.
K . Whiteheud
A.E. Seymour
Microlm and /nfeciions of the Gut. S. C . GOODWIN Blackwcll Scientific Book Distributors, Highett, Victoria. $42.50. ISBN 0-86793-104-3. 377 p p . , illustrated. Infectious disease is one of the most rapidly expanding fields of medicine and infections involving (he gut are no exception to this rule. This book covers a wider subject than microbial gastroenteritis. There are useful chapters on the gut flora and the immunology of the gut. The greater part of the book is devoted to microbial diarrheas and as well as old favourites (salmonellosis, entcropathogenic E. coli) it considers newer pathogens (Aeromonus, thc halophilic vibrios, Clostridium dij]icile). The remainder is devoted to organisms which produce clinical states not necessarily associated with diarrhea such as infant botulism, Yersinia infection of the gut parenchyma, bacterial overgrowth syndromes, and post-operative wound infections after abdominal surgery. The next edition will need a chapter on the gut and AIDS, and on Cumpylohucter pyloris and its possible role in peptic ulcer. Goodwin has assembled a capable team of authors for this project and the result contributes not only to the diagnosis of various forms of diarrhea, but to the understanding of the complex interactions between the gut, its normal flora and its invader?. V. Ackerman
Diugnosric Ultrustructurul Puthology: A self evaluation manual. F. N. GtmDtALi Y Butterworths, London, 1984. 110 pp.. 50 photographs fY.95. ISBN 407003568. Professor Ghadially is a major international figure in electron microscopy ( E M ) and has visited Australia several times. He has written a major reference work (“The ultrastructural pathology of the cell”) and a useful introductory guide (“Diagnostic electron microscopy of tumours”), each published by Butterworths. Now he has entered into a tertiary phase and collected a series of micrographs for those wishing “to acquire a fair amount of .....knowledge” about ultrastructural pathology “without much expenditure of time or money”. The selection of micrographs has been restricted largely to conditions showing “specific diagnostic patterns” where “the diagnosis can be made at a glance with little background information”. Would that these conditions occurred more commonly in normal practice! There are no light micrographs and the 50 cases are presented with a brief history and several specific questions about the diagnosis and morphological features. About half the micrographs are concerned with turnours and 15 illustrate cytoplasmic dense - core granules of one sort or another (3 micrographs are devoted to melanosomes). Non-neoplastic conditions illustrated include storage diseases (4 micrographs), glomerular lesions (4) and blood disorders (6). The illustrations are excellent-as we have come to expect from Professor Ghadially-and the short commentaries, though variable in quality, usually are informative; references generally arc to the author’s earlier books. I f this book-and others in the genre-is to be useful to the trainee or established diagnostic pathologist, it should demonstrate the value of EM in day to day practice. So it does. Most commentaries stress the information that can be gained only from the electron micrographsometimes to an impractical degree-and there is much to be learned. But the book has no theme, the approach to learning is fragmentary and the all important question-which problems are likely to be resolved by EM?-is not addressed. Worse, some commentaries suggest that differentiation between benign and malignant tumours is possible by
Bone Marrow Biopsies RevisitedA New Dimension f o r Hemutologicul Malignancies. R. BARTL.B. FRISCHA N D R. BURKHARDT. 2nd revised edition. S. Karger, Basel, Miinchen, Paris, London, New York, Tokyo, Sydney. 1985. SFr58.-; DM69.-; US$34.75. ISBN 3-8055-3937-1. 138 pp., illustrated. This is an eminently readable book of 130 pages containing 78 figures and 18 tables, all of which are clear and concise. The quality of production of the sixteen colour plates is excellent and shows a brilliant morphology obtainable only by plastic embedding. Bone marrow is the last area in the body to be intensively explored by histological techniques, hence new and practical facts are emerging rapidly, indicating the need for this second edition. The hematologist has depended on the results of bone marrow aspirates alone up till the 1960’s. It then became clear, as aspiration and trephine biopsy were combined, that the cells we most needed to examine were so often those which were most densely confined by reticulin fibres. The guide lines for their interpretation and for the widely differing marrow patterns found in what have hitherto appeared to be closely allied conditions, direct us through this edition to a more definite and clinically helpful diagnosis, frequently with prognostic significance. The book emphasises the importance of good processing in the preparation of marrow cores and the significant part which can be played by immunological techniques. The normal and orderly production of the various cell lines in their respective sites in bone marrow has been succinctly presented. Without this recent and essential knowledge we have been floundering in our approach to bone marrow histology. From these observations the authors have proceeded to clarify the findings in such conditions as the myelodysplastic syndromes. From this text we now have additional parameters to observe in the assessment of prognosis in multiple myeloma and similarly in the NonHodgkin’s and Hodgkin’s lymphomas. In the former they have also presented data which can alert the hematologist-histopathologist to the special characteristics of some infiltrates which might otherwise have been considered to be follicular and reactive groups of cells. The book deals with all the important hematological conditions which may be found in bone marrow. It is a rich source of reference material and as such is a comprehensive treatise on our current knowledge of bone marrow pathology as it relates to hematological disease. It is strongly recommended as an essential addition to the library of those involved in the interpretation of bone marrow cores. R. Horsley
Leucocyte Typing-Human Leucocyte Differentiation Antigens Detected by Monoclonal Antibodies. Eds. A. BERNARD, L. BOUMSELL, J. DAUSSET, C. MILSTEIN A N D S . F. SCHLOSSMAN. 1984. Springer-Verlag, Berlin, Heidelberg, New York, Tokyo. ISBN 3-540-12056-4, 814 pp, illustrated US$48.60. This book contains the proceedings of the First International Workshop on Human Leukocyte Differentiation Antigens, held in Paris in November, 1982. The aim of the meeting, convened by the leading international figures in this field, was to attempt to classify and produce a standard nomenclature for the rapidly increasing profusion of murine monoclonal antibodies reactive with human leukocytes. In a major
BOOK R E V I E W S
confusing to the average medical student. This is not a book which could easily meet all the requirements of an undergraduate in the average current style curriculum and could not be recommended as a set text. Nevertheless because it represents a first class collection of excellent colour photographs of gross pathology, some examples of which are quite I-are, it should be an acquisition of every medical library.
EM study alone and there are a number of other statements that could confuse or mislead the trainee. All in all, the book fulfils its small print I found it stimulating and title-“a self evaluation manual”-and rewarding as a quick revision of “spot diagnoses ”. But it provides neither a reliable guide nor an introduction to “diagnostic ultrastructural pathology” and cannot be recommended to the novice.
K . Whiteheud
A.E. Seymour
Microlm and /nfeciions of the Gut. S. C . GOODWIN Blackwcll Scientific Book Distributors, Highett, Victoria. $42.50. ISBN 0-86793-104-3. 377 p p . , illustrated. Infectious disease is one of the most rapidly expanding fields of medicine and infections involving (he gut are no exception to this rule. This book covers a wider subject than microbial gastroenteritis. There are useful chapters on the gut flora and the immunology of the gut. The greater part of the book is devoted to microbial diarrheas and as well as old favourites (salmonellosis, entcropathogenic E. coli) it considers newer pathogens (Aeromonus, thc halophilic vibrios, Clostridium dij]icile). The remainder is devoted to organisms which produce clinical states not necessarily associated with diarrhea such as infant botulism, Yersinia infection of the gut parenchyma, bacterial overgrowth syndromes, and post-operative wound infections after abdominal surgery. The next edition will need a chapter on the gut and AIDS, and on Cumpylohucter pyloris and its possible role in peptic ulcer. Goodwin has assembled a capable team of authors for this project and the result contributes not only to the diagnosis of various forms of diarrhea, but to the understanding of the complex interactions between the gut, its normal flora and its invader?. V. Ackerman
Diugnosric Ultrustructurul Puthology: A self evaluation manual. F. N. GtmDtALi Y Butterworths, London, 1984. 110 pp.. 50 photographs fY.95. ISBN 407003568. Professor Ghadially is a major international figure in electron microscopy ( E M ) and has visited Australia several times. He has written a major reference work (“The ultrastructural pathology of the cell”) and a useful introductory guide (“Diagnostic electron microscopy of tumours”), each published by Butterworths. Now he has entered into a tertiary phase and collected a series of micrographs for those wishing “to acquire a fair amount of .....knowledge” about ultrastructural pathology “without much expenditure of time or money”. The selection of micrographs has been restricted largely to conditions showing “specific diagnostic patterns” where “the diagnosis can be made at a glance with little background information”. Would that these conditions occurred more commonly in normal practice! There are no light micrographs and the 50 cases are presented with a brief history and several specific questions about the diagnosis and morphological features. About half the micrographs are concerned with turnours and 15 illustrate cytoplasmic dense - core granules of one sort or another (3 micrographs are devoted to melanosomes). Non-neoplastic conditions illustrated include storage diseases (4 micrographs), glomerular lesions (4) and blood disorders (6). The illustrations are excellent-as we have come to expect from Professor Ghadially-and the short commentaries, though variable in quality, usually are informative; references generally arc to the author’s earlier books. I f this book-and others in the genre-is to be useful to the trainee or established diagnostic pathologist, it should demonstrate the value of EM in day to day practice. So it does. Most commentaries stress the information that can be gained only from the electron micrographsometimes to an impractical degree-and there is much to be learned. But the book has no theme, the approach to learning is fragmentary and the all important question-which problems are likely to be resolved by EM?-is not addressed. Worse, some commentaries suggest that differentiation between benign and malignant tumours is possible by
Bone Marrow Biopsies RevisitedA New Dimension f o r Hemutologicul Malignancies. R. BARTL.B. FRISCHA N D R. BURKHARDT. 2nd revised edition. S. Karger, Basel, Miinchen, Paris, London, New York, Tokyo, Sydney. 1985. SFr58.-; DM69.-; US$34.75. ISBN 3-8055-3937-1. 138 pp., illustrated. This is an eminently readable book of 130 pages containing 78 figures and 18 tables, all of which are clear and concise. The quality of production of the sixteen colour plates is excellent and shows a brilliant morphology obtainable only by plastic embedding. Bone marrow is the last area in the body to be intensively explored by histological techniques, hence new and practical facts are emerging rapidly, indicating the need for this second edition. The hematologist has depended on the results of bone marrow aspirates alone up till the 1960’s. It then became clear, as aspiration and trephine biopsy were combined, that the cells we most needed to examine were so often those which were most densely confined by reticulin fibres. The guide lines for their interpretation and for the widely differing marrow patterns found in what have hitherto appeared to be closely allied conditions, direct us through this edition to a more definite and clinically helpful diagnosis, frequently with prognostic significance. The book emphasises the importance of good processing in the preparation of marrow cores and the significant part which can be played by immunological techniques. The normal and orderly production of the various cell lines in their respective sites in bone marrow has been succinctly presented. Without this recent and essential knowledge we have been floundering in our approach to bone marrow histology. From these observations the authors have proceeded to clarify the findings in such conditions as the myelodysplastic syndromes. From this text we now have additional parameters to observe in the assessment of prognosis in multiple myeloma and similarly in the NonHodgkin’s and Hodgkin’s lymphomas. In the former they have also presented data which can alert the hematologist-histopathologist to the special characteristics of some infiltrates which might otherwise have been considered to be follicular and reactive groups of cells. The book deals with all the important hematological conditions which may be found in bone marrow. It is a rich source of reference material and as such is a comprehensive treatise on our current knowledge of bone marrow pathology as it relates to hematological disease. It is strongly recommended as an essential addition to the library of those involved in the interpretation of bone marrow cores. R. Horsley
Leucocyte Typing-Human Leucocyte Differentiation Antigens Detected by Monoclonal Antibodies. Eds. A. BERNARD, L. BOUMSELL, J. DAUSSET, C. MILSTEIN A N D S . F. SCHLOSSMAN. 1984. Springer-Verlag, Berlin, Heidelberg, New York, Tokyo. ISBN 3-540-12056-4, 814 pp, illustrated US$48.60. This book contains the proceedings of the First International Workshop on Human Leukocyte Differentiation Antigens, held in Paris in November, 1982. The aim of the meeting, convened by the leading international figures in this field, was to attempt to classify and produce a standard nomenclature for the rapidly increasing profusion of murine monoclonal antibodies reactive with human leukocytes. In a major