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Pathology of Human Neoplasms: An Atlas of Diagnostic Electron Microscopy and Immunohistochemistry
1272
BOOK REVIEWS
Mayo Clin Proc, December 1988, Vol 63
physiologic mechanisms, and some aspects of treatment. A lack of organization and a desire to cover all aspects of headache for the clinician detract from the effectiveness of this chapter. The contribution on cluster headache offers superficial coverage and does not seem to reflect the experience of an expert in the treatment of this most terrible of the headache syndromes. This book is neither a comprehensive textbook of headache nor a source to consult regarding the treatment of a particular type of head pain. Little specific information is provided on dosage, route of administration, and timing of drugs. The strengths of the book are the review of classic migraine, the material on the surgical treatment of trigeminal neuralgia, the section on postherpetic neuralgia, and the discussion of the expectations of patients who seek help from various strata of medical care. For physicians who provide specialty care for headache victims, the work is recommended reading; for the nonspecialist, the book offers a wealth of important information, but it is by no means a reference text on headache. For this purpose, several better texts are currently available. J. Keith Campbell, M.D. Department of Neurology
Pathology of Human Neoplasms: An Atlas of Diagnostic Electron Microscopy and Immunohistochemistry, edited by Henry A. Azar, 638 pp, with illus, $99, New York, Raven Press, 1988 As the characterization of human neoplasms continues to progress—slowly and steadily in ultrastructure, explosively in immunohistology—the diagnostic pathologist is overwhelmed. Current issues of journals are viewed with a mixture of interest and anxiety—what new markers are to be ascribed to which of our standing inventory of tumor types? This new text is effectively directed at this problem and comprehensively updates all major categories of human tumors—and not only in respect to immunologic and ultrastructural markers. Although designated an atlas, the book is much more than that. Its distinguished authorship consistently offers the reader a modern,
well-organized, conceptual understanding of each organ system and related neoplasms. Some chapters offer truly brilliant introductions. For example, in the chapter on neuroendocrine tumors, Drs. Hammar and Gould provide a historical review, a summary of currently accepted biologic observations, and a unifying synthesis for understanding neoplasms of the "dispersed neuroendocrine system." Before thoroughly reviewing tumor types and respective markers, the authors explain the biologic derivation of these markers. Pathologists will revel in the association of function or organelle structure with those heretofore mysterious terms such as "neuronspecific enolase," "chromogranin," and "synaptophysin." Many chapters contain useful, concise tables for reviewing markers—for example, those that list antigens for hematolymphoid processes and compare the new, standardized "CD" designations to those used by commercial or independent laboratories. Each author provides an impressive array of case examples, and, without exception, the quality of the photomicrographs and the printing is excellent. Karyotypic, genetic probe analysis, and cell culture findings are included for relevant tumors. The shortcomings of this book are those implicit in such an ambitious undertaking. Some slight variation in format is evident among the chapters. Only one chapter—that on round cell tumors—consists entirely of case presentations. In addition, a few distinctive cell types have been overlooked. The protean variations of histiocytes are represented only with descriptions of monocytes and Langerhans cells. Understandably in so current a subject as immunostaining, some descriptions have become outdated since the book went to press. For example, cytokeratin has been demonstrated to be expressed in both smooth muscle tumors and malignant fibrous histiocytomas, whereas in this book it is described as a marker distinctive for epithelioid and synovial sarcomas among soft tissue tumors. Perhaps the strongest attribute of this book is its practical emphasis on conventional clinicalhistologic criteria for the definition of tumors. This critical starting point for further characterization of neoplasms is not taken for granted. Dr. Azar and coauthors are to be commended for retaining the old while emphasizing the new. Every diagnostic pathologist will find this book a valuable ally. The introductory chapters, which
1273
BOOK REVIEWS
Mayo Clin Proc, December 1988, Vol 63
address "attributes of human neoplasms" and "principles of immunohistochemistry," should be read immediately for their broad applications. Subsequent chapters can be recruited into use as needed in pursuit of active case studies. Peter M. Banks, M.D. Department of Laboratory Medicine and Pathology
Infections in the Rheumatic Diseases: A Comprehensive Review of Microbial Relations to Rheumatic Disorders, edited by Luis Espinoza, Don L. Goldenberg, Frank C. Arnett, and Graciela S. Alarcon, 383 pp, with illus, $89.50, Philadelphia, Grune & Stratton, 1988 An understanding of the multiple roles of infection is crucial to the proper diagnosis and treatment of an important segment of arthritic disorders. This book brings together in a single volume of manageable size the known relationships between recognized infectious agents and a wide spectrum of rheumatic diseases. It provides a more comprehensive discussion of infection-host-joint interactions (accompanied by extensive references) than can be found in standard textbooks of medicine or rheumatology. The thrust of the book is primarily rheumatologic; approximately half the authors are rheumatologists, and the remainder represent other disciplines including infectious diseases, epidemiology, and orthopedics. Some contributors are recognized experts on their topics, whereas others are less well known. The book is divided into four parts. The first three are devoted to septic arthritis caused by bacterial, viral, and many rare pathogenic organisms. The fourth section reviews the reactive arthritic disorders—those sterile inflammatory joint diseases that are caused by an infection at a distant site. The contents are up-to-date, as demonstrated by the inclusion of a chapter that describes the recently recognized association between the acquired immunodeficiency syndrome (AIDS) and Reiter's syndrome. Much of the material is straightforward, with the emphasis on clinical manifestations of infection. One especially commendable chapter in the first three parts of the text is Koopman's "Im-
munopathogenetic Mechanisms in Viral Disease." The primary attraction, however, is part IV, edited by Frank C. Arnett, which covers the reactive arthritic disorders. State-of-the-art chapters in this section review the complex interrelationships of infectious agents, immunology, and genetics. One might quibble with the implication that Whipple's disease is a form of reactive arthritis, but that is a minor issue. The chapter that speculates on the possible association of psoriatic arthritis with an infectious cause comes as a surprise but offers a fresh perspective in analyzing the relationship between this chronic or recurrent skin eruption and a sometimes devastating form of arthritis. This comprehensive review is an admirable first effort, but it contains significant flaws. The space devoted to infectious arthritis in children is disappointingly small. A generous chapter on this important topic would be a welcome addition for rheumatologists and pediatricians alike. The quality of the chapters varies considerably, even more than one would expect in a multiauthored textbook. Several chapters contain an unacceptable number of errors. Misspelled words and poor grammar are just a few of the flaws that distract the reader and make the scholarship of the affected chapters suspect. This text will appeal primarily to rheumatologists and specialists in infectious diseases. Perhaps some internists and orthopedic surgeons will find it useful as well. Joseph Duffy, M.D. Division of Rheumatology and Internal Medicine
Indications in Vascular Surgery, edited by Roger M. Greenhalgh, 446 pp, with illus, $95, Philadelphia, W. B. Saunders Company, 1988 In this text, the editor, Roger Greenhalgh, has assembled comments on issues of surgical judgment from an international group of surgeons. Which patients should undergo operation for various arterial, venous, and lymphatic problems? His goal was a clear definition of internationally acceptable surgical indications. He is quick to point out, however, that "there are differences in various parts of the world." Consequently, the book actually presents a clear defi-
BOOK REVIEWS
Mayo Clin Proc, December 1988, Vol 63
physiologic mechanisms, and some aspects of treatment. A lack of organization and a desire to cover all aspects of headache for the clinician detract from the effectiveness of this chapter. The contribution on cluster headache offers superficial coverage and does not seem to reflect the experience of an expert in the treatment of this most terrible of the headache syndromes. This book is neither a comprehensive textbook of headache nor a source to consult regarding the treatment of a particular type of head pain. Little specific information is provided on dosage, route of administration, and timing of drugs. The strengths of the book are the review of classic migraine, the material on the surgical treatment of trigeminal neuralgia, the section on postherpetic neuralgia, and the discussion of the expectations of patients who seek help from various strata of medical care. For physicians who provide specialty care for headache victims, the work is recommended reading; for the nonspecialist, the book offers a wealth of important information, but it is by no means a reference text on headache. For this purpose, several better texts are currently available. J. Keith Campbell, M.D. Department of Neurology
Pathology of Human Neoplasms: An Atlas of Diagnostic Electron Microscopy and Immunohistochemistry, edited by Henry A. Azar, 638 pp, with illus, $99, New York, Raven Press, 1988 As the characterization of human neoplasms continues to progress—slowly and steadily in ultrastructure, explosively in immunohistology—the diagnostic pathologist is overwhelmed. Current issues of journals are viewed with a mixture of interest and anxiety—what new markers are to be ascribed to which of our standing inventory of tumor types? This new text is effectively directed at this problem and comprehensively updates all major categories of human tumors—and not only in respect to immunologic and ultrastructural markers. Although designated an atlas, the book is much more than that. Its distinguished authorship consistently offers the reader a modern,
well-organized, conceptual understanding of each organ system and related neoplasms. Some chapters offer truly brilliant introductions. For example, in the chapter on neuroendocrine tumors, Drs. Hammar and Gould provide a historical review, a summary of currently accepted biologic observations, and a unifying synthesis for understanding neoplasms of the "dispersed neuroendocrine system." Before thoroughly reviewing tumor types and respective markers, the authors explain the biologic derivation of these markers. Pathologists will revel in the association of function or organelle structure with those heretofore mysterious terms such as "neuronspecific enolase," "chromogranin," and "synaptophysin." Many chapters contain useful, concise tables for reviewing markers—for example, those that list antigens for hematolymphoid processes and compare the new, standardized "CD" designations to those used by commercial or independent laboratories. Each author provides an impressive array of case examples, and, without exception, the quality of the photomicrographs and the printing is excellent. Karyotypic, genetic probe analysis, and cell culture findings are included for relevant tumors. The shortcomings of this book are those implicit in such an ambitious undertaking. Some slight variation in format is evident among the chapters. Only one chapter—that on round cell tumors—consists entirely of case presentations. In addition, a few distinctive cell types have been overlooked. The protean variations of histiocytes are represented only with descriptions of monocytes and Langerhans cells. Understandably in so current a subject as immunostaining, some descriptions have become outdated since the book went to press. For example, cytokeratin has been demonstrated to be expressed in both smooth muscle tumors and malignant fibrous histiocytomas, whereas in this book it is described as a marker distinctive for epithelioid and synovial sarcomas among soft tissue tumors. Perhaps the strongest attribute of this book is its practical emphasis on conventional clinicalhistologic criteria for the definition of tumors. This critical starting point for further characterization of neoplasms is not taken for granted. Dr. Azar and coauthors are to be commended for retaining the old while emphasizing the new. Every diagnostic pathologist will find this book a valuable ally. The introductory chapters, which
1273
BOOK REVIEWS
Mayo Clin Proc, December 1988, Vol 63
address "attributes of human neoplasms" and "principles of immunohistochemistry," should be read immediately for their broad applications. Subsequent chapters can be recruited into use as needed in pursuit of active case studies. Peter M. Banks, M.D. Department of Laboratory Medicine and Pathology
Infections in the Rheumatic Diseases: A Comprehensive Review of Microbial Relations to Rheumatic Disorders, edited by Luis Espinoza, Don L. Goldenberg, Frank C. Arnett, and Graciela S. Alarcon, 383 pp, with illus, $89.50, Philadelphia, Grune & Stratton, 1988 An understanding of the multiple roles of infection is crucial to the proper diagnosis and treatment of an important segment of arthritic disorders. This book brings together in a single volume of manageable size the known relationships between recognized infectious agents and a wide spectrum of rheumatic diseases. It provides a more comprehensive discussion of infection-host-joint interactions (accompanied by extensive references) than can be found in standard textbooks of medicine or rheumatology. The thrust of the book is primarily rheumatologic; approximately half the authors are rheumatologists, and the remainder represent other disciplines including infectious diseases, epidemiology, and orthopedics. Some contributors are recognized experts on their topics, whereas others are less well known. The book is divided into four parts. The first three are devoted to septic arthritis caused by bacterial, viral, and many rare pathogenic organisms. The fourth section reviews the reactive arthritic disorders—those sterile inflammatory joint diseases that are caused by an infection at a distant site. The contents are up-to-date, as demonstrated by the inclusion of a chapter that describes the recently recognized association between the acquired immunodeficiency syndrome (AIDS) and Reiter's syndrome. Much of the material is straightforward, with the emphasis on clinical manifestations of infection. One especially commendable chapter in the first three parts of the text is Koopman's "Im-
munopathogenetic Mechanisms in Viral Disease." The primary attraction, however, is part IV, edited by Frank C. Arnett, which covers the reactive arthritic disorders. State-of-the-art chapters in this section review the complex interrelationships of infectious agents, immunology, and genetics. One might quibble with the implication that Whipple's disease is a form of reactive arthritis, but that is a minor issue. The chapter that speculates on the possible association of psoriatic arthritis with an infectious cause comes as a surprise but offers a fresh perspective in analyzing the relationship between this chronic or recurrent skin eruption and a sometimes devastating form of arthritis. This comprehensive review is an admirable first effort, but it contains significant flaws. The space devoted to infectious arthritis in children is disappointingly small. A generous chapter on this important topic would be a welcome addition for rheumatologists and pediatricians alike. The quality of the chapters varies considerably, even more than one would expect in a multiauthored textbook. Several chapters contain an unacceptable number of errors. Misspelled words and poor grammar are just a few of the flaws that distract the reader and make the scholarship of the affected chapters suspect. This text will appeal primarily to rheumatologists and specialists in infectious diseases. Perhaps some internists and orthopedic surgeons will find it useful as well. Joseph Duffy, M.D. Division of Rheumatology and Internal Medicine
Indications in Vascular Surgery, edited by Roger M. Greenhalgh, 446 pp, with illus, $95, Philadelphia, W. B. Saunders Company, 1988 In this text, the editor, Roger Greenhalgh, has assembled comments on issues of surgical judgment from an international group of surgeons. Which patients should undergo operation for various arterial, venous, and lymphatic problems? His goal was a clear definition of internationally acceptable surgical indications. He is quick to point out, however, that "there are differences in various parts of the world." Consequently, the book actually presents a clear defi-