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Gastrointestinal Pathology: An Atlas and Text
Mayo Clin Proc, December 1989, Vol 64
and conditions, particularly in regard to the effectiveness of interventions in asymptomatic patients. The task force met 14 times between July 1984 and February 1988; thus, the report does not consider any evidence from investiga tions published after early 1988. Included with the text are summary cards that capsulize infor mation for the following age groups: birth through 18 months, years 2 through 6, 7 through 12, 13 through 18,19 through 39,40 through 64, and 65 and older. A summary of preventive services for pregnant women is also provided. Each sheet includes recommendations on screening and counseling and, when applicable, information concerning immunizations, leading causes of death, and conditions for which physicians should remain particularly alert in each age group. The task force rated the quality of the evi dence that supported the efficacy of the various clinical preventive interventions considered. Evidence from properly designed, randomized controlled trials was given special emphasis, whereas opinions of authorities, clinical experi ences, descriptive studies, and case reports re ceived lesser emphasis. Although this hierar chical approach may provide appropriate guid ance regarding laboratory or diagnostic proce dures and immunizations, I believe it is inade quate for the evaluation of the patient's history and findings on physical examination. For ex ample, for asymptomatic nonpregnant women, the task force recommendations for the physical examination include only measurement of height, weight, and blood pressure and, when appli cable, clinical breast examination and glaucoma testing; instruction in breast self-examination is not mentioned. For asymptomatic men, the task force does not recommend routine digital exami nation as a screening test for prostate cancer or routine palpation of the testes as a screening test for testicular cancer. To be fair, the text usually states that the task force found insufficient evi dence to recommend or oppose particular ma neuvers. Unfortunately, the separate quickreference summary tables do not include these qualifying statements. I hope that those who plan to implement these recommendations and potential payers for these clinical preventive
BOOK REVIEWS 1567
services will read and consider the entire text, not just the summaries. Despite the aforementioned observations, I believe that this comprehensive, well-written report is a positive step toward appropriate guidelines for clinical preventive services. I recommend that physicians first read the entire text and then, using the report as a guideline, depart from the recommendations when clinical judgment prevails. Carl F. Anderson, M.D. Division of Nephrology and Internal Medicine
Gastrointestinal Pathology: An Atlas and Text, by Cecilia M. Fenoglio-Preiser, Patrick E. Lantz, Margaret B. Listrom, Michael Davis, and Franco O. Rilke, 892 pp, with illus, $225, New York, Raven Press, 1989 This book begins with a good description of the structure of the normal gastrointestinal tract, followed by three chapters that deal with the normal anatomy of the esophagus and associ ated nonneoplastic lesions and tumors. In this general format, the book then considers the anatomy and pathology of the stomach and small bowel. Subsequent chapters are devoted to some aspects of the large intestine, including its nor mal anatomy, idiopathic inflammatory bowel disease, and polyposis; the vermiform appendix is accorded a chapter of its own. The concluding eight sections deal with hyperplasias and neo plasms of endocrine cells, mesenchymal tumors, and primary lymphomas of the gastrointestinal tract; two chapters review nonneoplastic and neoplastic lesions of the large bowel. Why these two chapters are so widely separated in the book from those dealing with other large bowel dis eases is unclear. Chapters 20 through 22 revert to the earlier format and describe normal anal anatomy and nonneoplastic diseases and neo plasms of the anus. The final section deals with cytology of the gastrointestinal tract.
1568 BOOK REVIEWS
Mayo Clin Proc, December 1989, Vol 64
Overall, this text is excellent—well written and adequately referenced. Its one weakness is that many of the photomicrographs are not of the best possible quality, a factor that diminishes their usefulness to the reader. Nevertheless, I recommend this book to anyone interested in gastrointestinal pathology, and I welcome it to my bookshelves. Roy G. Shorter, M.D. Division of Pathology
Pathology of Tumours of the Nervous Sys tem, 5th ed, by Dorothy S. Russell and Lucien J. Rubinstein, 1,012 pp, with illus, $175, Bal timore, Williams & Wilkins, 1989 The most recent edition of this text, dubbed with affection "R & R," represents the accumulated experience of two productive careers. Although the recent passing of Dr. Dorothy Russell brought one to a close, this beautiful book, carefully updated by Dr. Lucien Rubinstein, attests to the fruitfulness of their long association. The much-expanded text—twice the length of the 1977 edition—has been entirely reworked. The numerous improvements reflect recent advances in the experimental neurosciences, including tumor implantation studies in nude mice, cell proliferation and kinetics, and cytogenetic as well as immunocytochemical studies. Significantly expanded sections on the pathogenesis of tumors and experimental neoplasia stress the relevance of oncogenes, growth fac tors, membrane receptors, and tumor markers. The discussions of these developments, which demonstrate the contribution of basic research to our understanding of neoplasia, are skillfully woven throughout the text in order to highlight their diagnostic relevance. Numerous changes have rendered the book more "user friendly" than previous editions. Foremost among these changes are (1) the reor dering of the discussions of various lesions to reflect more closely the order of their importance
and (2) the more precise organization of refer ences under subheadings. In order of presenta tion, glial and neuronal neoplasms are given priority, followed by meningeal tumors and, finally, by other lesions frequently encountered in general surgical pathology. Considerable revision is apparent in the section on neuroendocrine and hematopoietic neoplasms. Of particu lar value is the section on the effects of irradia tion and chemotherapy on tumors. Rapid changes in the classification of pituitary adenomas and the availability of several specialty-oriented texts on the subject prompted the authors to de-em phasize the section on tumors of the pituitary and sellar region. Despite these changes in format, the basic style of the book remains unchanged. The text features an orderly approach throughout, begin ning with an overview of a particular lesion, putting it into historical perspective before embarking on descriptions of its gross and mi croscopic features, immunocytologic character istics, ultrastructure, and, where pertinent, an account of its properties in vitro. Frequent references to personal cases and anecdotes serve to relieve the information-packed format and provide clinical relevance. As in previous editions, the organization of the text and the tumor classification to which it adheres emphasize histogenesis. Nonetheless, because of its in-depth coverage of immunocytochemistry, electron microscopy, and tissue cul ture, the work provides a comprehensive view of cellular differentiation and artfully applies the concept to diagnosis. The immunohistochemical characteristics of numerous neoplasms are beau tifully illustrated in color plates that demon strate the reactivities important in differential diagnosis. The excellent electron photomicro graphs (approximately the same number as in the previous edition) demonstrate selected basic morphologic features of important lesions. Conspicuous by its absence is any reference to neuroimaging and its correlation with histopathology—a minor and understandable omission in view of current controversies in this area. Unlike massive tomes that purport to be "everything to everyone," this work is directed
and conditions, particularly in regard to the effectiveness of interventions in asymptomatic patients. The task force met 14 times between July 1984 and February 1988; thus, the report does not consider any evidence from investiga tions published after early 1988. Included with the text are summary cards that capsulize infor mation for the following age groups: birth through 18 months, years 2 through 6, 7 through 12, 13 through 18,19 through 39,40 through 64, and 65 and older. A summary of preventive services for pregnant women is also provided. Each sheet includes recommendations on screening and counseling and, when applicable, information concerning immunizations, leading causes of death, and conditions for which physicians should remain particularly alert in each age group. The task force rated the quality of the evi dence that supported the efficacy of the various clinical preventive interventions considered. Evidence from properly designed, randomized controlled trials was given special emphasis, whereas opinions of authorities, clinical experi ences, descriptive studies, and case reports re ceived lesser emphasis. Although this hierar chical approach may provide appropriate guid ance regarding laboratory or diagnostic proce dures and immunizations, I believe it is inade quate for the evaluation of the patient's history and findings on physical examination. For ex ample, for asymptomatic nonpregnant women, the task force recommendations for the physical examination include only measurement of height, weight, and blood pressure and, when appli cable, clinical breast examination and glaucoma testing; instruction in breast self-examination is not mentioned. For asymptomatic men, the task force does not recommend routine digital exami nation as a screening test for prostate cancer or routine palpation of the testes as a screening test for testicular cancer. To be fair, the text usually states that the task force found insufficient evi dence to recommend or oppose particular ma neuvers. Unfortunately, the separate quickreference summary tables do not include these qualifying statements. I hope that those who plan to implement these recommendations and potential payers for these clinical preventive
BOOK REVIEWS 1567
services will read and consider the entire text, not just the summaries. Despite the aforementioned observations, I believe that this comprehensive, well-written report is a positive step toward appropriate guidelines for clinical preventive services. I recommend that physicians first read the entire text and then, using the report as a guideline, depart from the recommendations when clinical judgment prevails. Carl F. Anderson, M.D. Division of Nephrology and Internal Medicine
Gastrointestinal Pathology: An Atlas and Text, by Cecilia M. Fenoglio-Preiser, Patrick E. Lantz, Margaret B. Listrom, Michael Davis, and Franco O. Rilke, 892 pp, with illus, $225, New York, Raven Press, 1989 This book begins with a good description of the structure of the normal gastrointestinal tract, followed by three chapters that deal with the normal anatomy of the esophagus and associ ated nonneoplastic lesions and tumors. In this general format, the book then considers the anatomy and pathology of the stomach and small bowel. Subsequent chapters are devoted to some aspects of the large intestine, including its nor mal anatomy, idiopathic inflammatory bowel disease, and polyposis; the vermiform appendix is accorded a chapter of its own. The concluding eight sections deal with hyperplasias and neo plasms of endocrine cells, mesenchymal tumors, and primary lymphomas of the gastrointestinal tract; two chapters review nonneoplastic and neoplastic lesions of the large bowel. Why these two chapters are so widely separated in the book from those dealing with other large bowel dis eases is unclear. Chapters 20 through 22 revert to the earlier format and describe normal anal anatomy and nonneoplastic diseases and neo plasms of the anus. The final section deals with cytology of the gastrointestinal tract.
1568 BOOK REVIEWS
Mayo Clin Proc, December 1989, Vol 64
Overall, this text is excellent—well written and adequately referenced. Its one weakness is that many of the photomicrographs are not of the best possible quality, a factor that diminishes their usefulness to the reader. Nevertheless, I recommend this book to anyone interested in gastrointestinal pathology, and I welcome it to my bookshelves. Roy G. Shorter, M.D. Division of Pathology
Pathology of Tumours of the Nervous Sys tem, 5th ed, by Dorothy S. Russell and Lucien J. Rubinstein, 1,012 pp, with illus, $175, Bal timore, Williams & Wilkins, 1989 The most recent edition of this text, dubbed with affection "R & R," represents the accumulated experience of two productive careers. Although the recent passing of Dr. Dorothy Russell brought one to a close, this beautiful book, carefully updated by Dr. Lucien Rubinstein, attests to the fruitfulness of their long association. The much-expanded text—twice the length of the 1977 edition—has been entirely reworked. The numerous improvements reflect recent advances in the experimental neurosciences, including tumor implantation studies in nude mice, cell proliferation and kinetics, and cytogenetic as well as immunocytochemical studies. Significantly expanded sections on the pathogenesis of tumors and experimental neoplasia stress the relevance of oncogenes, growth fac tors, membrane receptors, and tumor markers. The discussions of these developments, which demonstrate the contribution of basic research to our understanding of neoplasia, are skillfully woven throughout the text in order to highlight their diagnostic relevance. Numerous changes have rendered the book more "user friendly" than previous editions. Foremost among these changes are (1) the reor dering of the discussions of various lesions to reflect more closely the order of their importance
and (2) the more precise organization of refer ences under subheadings. In order of presenta tion, glial and neuronal neoplasms are given priority, followed by meningeal tumors and, finally, by other lesions frequently encountered in general surgical pathology. Considerable revision is apparent in the section on neuroendocrine and hematopoietic neoplasms. Of particu lar value is the section on the effects of irradia tion and chemotherapy on tumors. Rapid changes in the classification of pituitary adenomas and the availability of several specialty-oriented texts on the subject prompted the authors to de-em phasize the section on tumors of the pituitary and sellar region. Despite these changes in format, the basic style of the book remains unchanged. The text features an orderly approach throughout, begin ning with an overview of a particular lesion, putting it into historical perspective before embarking on descriptions of its gross and mi croscopic features, immunocytologic character istics, ultrastructure, and, where pertinent, an account of its properties in vitro. Frequent references to personal cases and anecdotes serve to relieve the information-packed format and provide clinical relevance. As in previous editions, the organization of the text and the tumor classification to which it adheres emphasize histogenesis. Nonetheless, because of its in-depth coverage of immunocytochemistry, electron microscopy, and tissue cul ture, the work provides a comprehensive view of cellular differentiation and artfully applies the concept to diagnosis. The immunohistochemical characteristics of numerous neoplasms are beau tifully illustrated in color plates that demon strate the reactivities important in differential diagnosis. The excellent electron photomicro graphs (approximately the same number as in the previous edition) demonstrate selected basic morphologic features of important lesions. Conspicuous by its absence is any reference to neuroimaging and its correlation with histopathology—a minor and understandable omission in view of current controversies in this area. Unlike massive tomes that purport to be "everything to everyone," this work is directed