- Email: [email protected]
Liver biopsy interpretation
1202 BOOKREVIEWS
Liver Biopsy Interpretation. Ed 5. By Peter J. Scheuer and Jay H. Lefkowitch, 315 pp. London: Saunders, 1994. $50. Practicing clinical hepatologists and gastroenterologists, as well as the generalist or specialist pathologist, faced with the need to seek practical help with liver biopsy specimen interpretation now have a surfeit of choices. During the past 3 years a number of superb new texts or revised editions of older texts dealing with the histopathology of the liver and biopsy diagnosis have been published. These include a number that have been reviewed in these pages: Dale Snover's Biopsy Diagnosis of Liver Disease, Jurgen Ludwig's Practical Liver Biopsy Interpretation, R. G. Lee's Diagnostic Liver Pathology, and the late Gerald Klatskin's and Hal Conn's Histopathology of the Liver. Other fine volumes, with a similar focus on the pathology of the liver, by Drs Wight, MacSween and colleagues, and Reubner and colleagues, also serve to highlight the importance of the subject. Publication of the fifth edition of the Scheuer book, the English granddaddy of works on liver biopsy, is particularly noteworthy because the last edition appeared 7 years ago in 1988; the first edition preceded that one by 20 years. Obviously, knowledge of liver disease has expanded dramatically, even since the fourth edition, and new technologies, e.g., those of molecular biology and immunocytochemistry, have added to the amount and kinds of information that can be collected from examination of liver biopsy specimens. Additionally, the global expansion of liver transplantation programs has increased the need of clinicians and pathologists to fully comprehend the utility of liver biopsy in the management of patients who have undergone transplantation. It should be noted that beginning with this edition, it will no longer be correct to cite this work as "the Scheuer"; Dr J a y Lefkowitch, a superb hepatopathologist at Columbia University's College of Physicians and Surgeons, has joined Dr Scheuer in the production of this major work. Among other contributions, Dr Lefkowitch is responsible for the chapters on liver transplantation and on the use of electron microscopy and other techniques. For those of us who have honed our skills through use of the earlier versions, the current edition will be particularly enjoyable and rewarding. In the several months I have had it in hand, I have found it extremely useful.
HEPATOLOGYApril 1995 It is beautifully written and carefully edited, with an abundance of sharply focused, black and white and color photomicrographs. Although a few wedge biopsy and autopsy specimens are used, the overwhelming number of photographs is derived from needle biopsy specimens. This is particularly important to practicing hepatologists and pathologists from a very functional point of view because liver biopsy specimen interpretation based on needle specimens is more relevant to our daily activities than is interpretation of autopsy pathology. Inclusion in each chapter of a large number of tables enhances the description of important histopathological or clinical features and also serves to break up the text into readily accessible segments. It is the text, however, which is the very firm foundation of this guide to interpretation. There is a wealth of excellent histopathological and clinical information contained herein. Descriptions of pathological features are provided in clear prose and consistently used terminology that never obscures the authors' meanings. The extensive reference lists, found at the end of each chapter, have been carefully selected and include citations from 1994. Additionally, background reading in the form of general references is also provided for all chapters. In addition to those mentioned above, chapter titles include, in order, "General Considerations," "Laboratory Techniques," "The Normal Liver," "Examination of the Abnormal Biopsy," and disease-oriented titles such as "Biliary Disease," "Acute Viral Hepatitis," "Fatty Liver and Lesions in the Alcoholic," "Drugs and Toxins," "Chronic Hepatitis," and "Cirrhosis." Neoplastic disease and hepatic nodules, vascular disorders of the liver, pediatric diseases, metabolic diseases and disorders of metal metabolism, and the liver in systemic disease and pregnancy comprise the remaining chapters. Hepatologists, hepatopathologists, trainees in hepatology and pathology, and even the seasoned general pathologist will find the "Scheuer and Lefkowitch" an appealing sourcebook of information on liver biopsy specimen interpretation. It is, in my view, a "best buy" among the widely available books dealing with this subject. A hearty congratulations to the authors seems appropriate. RAYMOND S. KOFF, MD
MetroWest Medical Center Framingham, MA
Liver Biopsy Interpretation. Ed 5. By Peter J. Scheuer and Jay H. Lefkowitch, 315 pp. London: Saunders, 1994. $50. Practicing clinical hepatologists and gastroenterologists, as well as the generalist or specialist pathologist, faced with the need to seek practical help with liver biopsy specimen interpretation now have a surfeit of choices. During the past 3 years a number of superb new texts or revised editions of older texts dealing with the histopathology of the liver and biopsy diagnosis have been published. These include a number that have been reviewed in these pages: Dale Snover's Biopsy Diagnosis of Liver Disease, Jurgen Ludwig's Practical Liver Biopsy Interpretation, R. G. Lee's Diagnostic Liver Pathology, and the late Gerald Klatskin's and Hal Conn's Histopathology of the Liver. Other fine volumes, with a similar focus on the pathology of the liver, by Drs Wight, MacSween and colleagues, and Reubner and colleagues, also serve to highlight the importance of the subject. Publication of the fifth edition of the Scheuer book, the English granddaddy of works on liver biopsy, is particularly noteworthy because the last edition appeared 7 years ago in 1988; the first edition preceded that one by 20 years. Obviously, knowledge of liver disease has expanded dramatically, even since the fourth edition, and new technologies, e.g., those of molecular biology and immunocytochemistry, have added to the amount and kinds of information that can be collected from examination of liver biopsy specimens. Additionally, the global expansion of liver transplantation programs has increased the need of clinicians and pathologists to fully comprehend the utility of liver biopsy in the management of patients who have undergone transplantation. It should be noted that beginning with this edition, it will no longer be correct to cite this work as "the Scheuer"; Dr J a y Lefkowitch, a superb hepatopathologist at Columbia University's College of Physicians and Surgeons, has joined Dr Scheuer in the production of this major work. Among other contributions, Dr Lefkowitch is responsible for the chapters on liver transplantation and on the use of electron microscopy and other techniques. For those of us who have honed our skills through use of the earlier versions, the current edition will be particularly enjoyable and rewarding. In the several months I have had it in hand, I have found it extremely useful.
HEPATOLOGYApril 1995 It is beautifully written and carefully edited, with an abundance of sharply focused, black and white and color photomicrographs. Although a few wedge biopsy and autopsy specimens are used, the overwhelming number of photographs is derived from needle biopsy specimens. This is particularly important to practicing hepatologists and pathologists from a very functional point of view because liver biopsy specimen interpretation based on needle specimens is more relevant to our daily activities than is interpretation of autopsy pathology. Inclusion in each chapter of a large number of tables enhances the description of important histopathological or clinical features and also serves to break up the text into readily accessible segments. It is the text, however, which is the very firm foundation of this guide to interpretation. There is a wealth of excellent histopathological and clinical information contained herein. Descriptions of pathological features are provided in clear prose and consistently used terminology that never obscures the authors' meanings. The extensive reference lists, found at the end of each chapter, have been carefully selected and include citations from 1994. Additionally, background reading in the form of general references is also provided for all chapters. In addition to those mentioned above, chapter titles include, in order, "General Considerations," "Laboratory Techniques," "The Normal Liver," "Examination of the Abnormal Biopsy," and disease-oriented titles such as "Biliary Disease," "Acute Viral Hepatitis," "Fatty Liver and Lesions in the Alcoholic," "Drugs and Toxins," "Chronic Hepatitis," and "Cirrhosis." Neoplastic disease and hepatic nodules, vascular disorders of the liver, pediatric diseases, metabolic diseases and disorders of metal metabolism, and the liver in systemic disease and pregnancy comprise the remaining chapters. Hepatologists, hepatopathologists, trainees in hepatology and pathology, and even the seasoned general pathologist will find the "Scheuer and Lefkowitch" an appealing sourcebook of information on liver biopsy specimen interpretation. It is, in my view, a "best buy" among the widely available books dealing with this subject. A hearty congratulations to the authors seems appropriate. RAYMOND S. KOFF, MD
MetroWest Medical Center Framingham, MA