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Pathology of Human Disease
BOOK REVIEWS
reproducible criteria, which might allow the recognition of follicle mantle cell lymphoma and certain variants thereof.
KYUNG-WHAN MIN , MD Oklahoma Medical Center Oklahoma City, OK
J. H .J. M. VAN KRIEKEN, MD, PHD C. VON SCHILLING, MD PH. M. KLUIN, MD, PHD K. UNNERT, MD, PHD University Hospital Leiden, The Netherlands
I. Gyorkey F. Min K-W. SinkovicsJG. et a1: Tubular structures resem bling nucleoprotein strand. of myxovirus in systemic lupu. erythematosus. N Engl J Med 280:333. 1969
The above letter was referred to the authors of the article in question, who offer thefollowing reply:
OrigIn and Nature of Tubuloreflcular Structures
To the Editor:-I read with great pleasure the article entitled "Tubuloreticular Structures and Cylindrical Confronting Cisternae: A Review" by Luu et aI (Human Pathology 20:617-627, 1989). The review was timely , thorough, and up to date. However, the authors failed to focus attention to the contribution made in the late 1960s. It is true that the true nature of tubuloreticular structures (TRS) is being unveiled and our understanding of TRS is ever evolving. In 1969, we reported the consistent presence ?f ~icrotubulari~c1usio?s in the endothelial cells in renal biopsies of five patients with SLE and thought they represented the nucleocapsids of paramyxoviruses. I This possibility of viral origin of TRS provoked the interest of many investigators, and numerous publications listed in the review are the culmination of this interest. As an investigator who has been involved in this evolutionary process from the beginning, simply because of being one of the investigators of the article which may have started it all, I feel a duty to bring deserved attention to the article which was omitted in the review.
BOOKRMEWS There are several texts devoted to either general pathology alone or both general and systemic pathology, which are either shorter than the standard reference textbooks or are in soft cover. The stated objectives of these books and their formats and styles vary greatly, and their usefulness will depend on the needs of the reader. Two recent soft-hound volumes address both general mechanisms of disease and the disorders of organ systems: Pathology. The Mechanisms of Disease, ed 2. Roderick A. Cawson, Alexander W. McCracken, Peter B. Marcus, et al. St Louis, MO, Mosby, 1989, 578 pages, $37.95. Pathology of Human Disease. John B. Walter. Philadelphia, PA, Lea & Febiger, 1989, 1,013 pages. Cawson et al devote somewhat more than a quarter of their book to general pathology, starting with a useful overview of normal cell biology and continuing with concise chapters on genetic and nutritional diseases and effects of physical a~ents before th~ traditional sections ~n inflammation, repair, and neoplasia, The chapters on diseases of the organ systems usually begin with a brief overview of pertinent anatomy and physiology, and include a summary of methods of clinical investigations of the system. The selection of disorders for discussion is not comprehensive but seems to be qu ite judicious. with appropriate attention to new information. There are well-chosen, sharply repro-
To the Editor:-I would like to thank Dr Min for his letter concerning our article on tubuloreticular structures (TRC) and cylindrical confronting cisternae (Ccq. We are aware of the contributions of Dr Min and his coworkers concerning TRS. We did not think it was possible to cite every article that had been published concerning TRS and CCC. I would like to point out that in reference 1 of our review article, Dr Min's article is cited as reference 10. I would also like to point out that in an article we published in the American Reviewof Respiratory Disease in 1983, we cited Dr Min's article as reference 17. In addition, reference 15 in our review article in Human Pathology cites an article by Drs Gyorkey, Sinkovics, Min, and coworkers published in 1972. We thought this article was somewhat of a review of the excellent work these investigators have done. We would like to apologize to Dr Min and colleagues for any misunderstanding that might have occurred as a result of our not citing their 1969 article directly. Again , we are certainly aware of the excellent work Dr Min and coworkers have done, and hope they will continue to add information to the literature concerning TRS and CCC. SAMUEL P. HAMMAR, MD Diagnostic Specialties Laboratory Bremerton, WA 98310
duced photographs and clear diagrams, and the limited number of selected references emphasizes recent reviews rather than primary sources. The authors state that the book is intended to enable a wide range of health care professionals who are newcomers to the field (including medical students) to gain an ideal of the scope of human disease without being overwhelmed by detail, and they have effectively met this goal. The larger book by Walter is intended to serve as a medical student text for the core material in the field of pathology. The first sections on cell and tissue damage, inflammation, and healing are rather detailed, with numerous diagrams. More than 100 pages are devoted to infections and parasitic infestations. In the organ system chapters, emphasis is appropriately placed on pathogenesis and morbid anatomy of selected major disorders. In addition, these chapters attempt to cover a number of the other less complex or rarer conditions in a large number of short sections, the treatment of many of which seems rather superficial. These sections perhaps make the scope of coverage too ambitious, and tend to put this book into unfortunate competition with the larger reference textbooks. The author acknowledges the use of many illustrations from his previous textbooks. The quality of these is not uniform. While many of the pictures are quite good, there are a few fuzzy photomicrographs. and some of the gross illustrations are too small to be fully effective. The selected references include important recent primary sources, reviews, other textbooks, and a large number of editorials. The choice of
1227
HUMAN PATHOLOGY
Volume 20. No. 12 (December 1989)
the title is a curious tautology, but the content may make this volume suitable for use with some pathology courses. Three shorter soft-cover volumes are in outline form, and are likely to be of more interest to someone seeking to review the subject than to a student new to the field: Pathology. ed 2. The National Medical Series for Independent Study. Virginia A. LiVolsi,John S.]. Brooks, Maria]. Merino, et al. New York, NY, Wiley, 1989, 534 pages. Key Facts in Pathology. Para Chandrasoma, Clive R. Taylor. New York , NY, Churchill-Livingstone, 1986, 445 pages . Aids to Pathology. M. F. Dixon. New York, NY, ChurchillLivingstone, 1985,322 pages. The authors of the first, and most comprehensive, of the books listed state that the book is intended to be used for review, not as a primary textbook. It includes several features designed to facilitate its use for this purpose, including a section on how to approach the National Board of Medical Examiners tests, and 500 board-type questions with thoroughly annotated answers. Although the text is in outline form, much of it is fleshed out into quite readable long phrases and complete sentences. The scope of coverage is generally comparable to the textbooks described above. The contents are very much up-to-date, but there are no references. The text is supplemented with several clear diagrams and a number of gross pictures and photomicrographs. The illustrations are generally quite wellreproduced, except for a few of the gross pictures which are too dark. This volume can certainly be recommended to students and others who want a detailed recall of the subject prior to taking a board type examination. The authors of the second volume set forth with a more ambitious objective, namely, to supply the basic information concerning the field of pathology needed by second-year medical students. The outline form is frequently expanded into phrases and sentences, and the text is accompan ied by clear diagrams and a selected number of photographs, some of which are not clear. Although the descriptive material about specific diseases is fairly comprehensive, the format seems poorly suited to a lucid presentation of pathogenesis, which puts this volume out of contention as a recommended primary text . There are no references. Although this book does not include study questions and annotated answers, it could be useful for purposes of review. The subject matter of the third volume is also presented in an outline form, but there is much less expanded text than in those books described above. There are a few tables and diagrams and no photographs. Selected references at the end of each chapter include reviews and some pr imary sources. Approximately two thirds of the book is devoted to general pathology, and the coverage of this area is somewhat more detailed than that of the organ systems which are presented in the barest factual outlines. Pathology. Understanding Human Disease, ed 2. Abner Golden , Deborah Powell, C. Darrell Jennings. Baltimore, MD, Williams & Wilkins, 1985, 568 pages, $31. The authors state that this book is intended to be one that can be read from cover to cover by students to provide perspective, understanding, and a sense that they have been introduced to the study of disease . A bit more than a quarter of the text deals with general mechanisms. The greater part of the remainder treats disorders by systems. In addition, there is a chapter on pediatric disorders and a section that surveys the use of the clinical laboratory with
specific attention to many of the most important tests. The text is lucid, and the choice of topics for inclusion seems apt. References are primarily selected reviews. There is no attempt to "cover" each system by superficial treatment of the generally less common diseases that are otherwise omitted. On the whole, more space and greater emphasis are given to pathogenesis than to description of lesions. The gross illustrations and photomicrographs are numerous and exceptional in the consistency of their high quality. The generous use of these excellent illustrations of the actual lesions is a refreshing contrast to the proliferation of drawings in some other new textbooks that may suggest that medical students or even pathologists no longer really need to look at organs or slides. This volume certainly seems suited to meet its objectives. Indeed, the scope and contents probably much more realistically reflect what medical students should be expected to comprehend than the contents of the "standard " textbooks. On the other hand, the need to refer to a source with more detail cannot be met by this book, and that is likely to reduce its appeal as a recommended course text. Two soft bound volumes are devoted to general pathology only: Essentials of General Pathology. John R. Warren, Dante G. Scarpelli,janardan K. Reddy, etal. New York, NY, Macmillan , 1987,259 pages. An Introduction to Disease. F. Stephen Vogel. Chicago, IL, Field , Rich & Associates, 1985, 248 pages. The first of these is intended to serve as an introductory text in general pathology for students in the biomedical sciences. In six chapters, the authors discuss inflammation , repair, cell injury, immunologic d isorders, and neoplasia in considerable detail, with emphasis on biochemical and molecular biologic mechanisms. The discussion of a few of the specific diseases chosen to illustrate these general topics, particularly in the section on infections, is comparable to the corresponding sections in texts of systemic pathology. Tables and diagrams are abundant, and the numerous gross and microscopic photographs are technical1y of high quality, even though many of them are very small. There are numerous references to contemporary, primary sources at the end of each chapter. This volume seems apt as a basic text for a course limited to general pathology and may also be useful to others seeking to update their understanding of basic disease mechanisms. Ostensibly, the volume by Vogel has a similar scope and objective to that of Warren et al, but there is an entirely different style and a greater emphasis on the "big picture" than on the finer points of molecular pathophysiology. The book is lavishly il\ustrated with excellent reproductions of gross pictures and sharp photomicrographs that fill half or more of the pages. An unusual feature is the inclusion of considerable clinical data in the captions . It is no surprise that this distinguished neuropathologist has chosen so many illustrations of the brain, but these effectively convey basic processes rather than specific details of neuropathology. This book strongly projects a point of view, and the writing has a personal style that may appeal less to some readers than to this one. While it is unlikely that many course directors would consider this to be an appropriate basic source text for medical students, it certainly provides a thought-provoking, and even entertaining, up-to-date overview for a more general readership.e-Ozoacs F. GRAY, MD, Professor of Pathology, Vanderbilt University, Nashville, TN.
1228
reproducible criteria, which might allow the recognition of follicle mantle cell lymphoma and certain variants thereof.
KYUNG-WHAN MIN , MD Oklahoma Medical Center Oklahoma City, OK
J. H .J. M. VAN KRIEKEN, MD, PHD C. VON SCHILLING, MD PH. M. KLUIN, MD, PHD K. UNNERT, MD, PHD University Hospital Leiden, The Netherlands
I. Gyorkey F. Min K-W. SinkovicsJG. et a1: Tubular structures resem bling nucleoprotein strand. of myxovirus in systemic lupu. erythematosus. N Engl J Med 280:333. 1969
The above letter was referred to the authors of the article in question, who offer thefollowing reply:
OrigIn and Nature of Tubuloreflcular Structures
To the Editor:-I read with great pleasure the article entitled "Tubuloreticular Structures and Cylindrical Confronting Cisternae: A Review" by Luu et aI (Human Pathology 20:617-627, 1989). The review was timely , thorough, and up to date. However, the authors failed to focus attention to the contribution made in the late 1960s. It is true that the true nature of tubuloreticular structures (TRS) is being unveiled and our understanding of TRS is ever evolving. In 1969, we reported the consistent presence ?f ~icrotubulari~c1usio?s in the endothelial cells in renal biopsies of five patients with SLE and thought they represented the nucleocapsids of paramyxoviruses. I This possibility of viral origin of TRS provoked the interest of many investigators, and numerous publications listed in the review are the culmination of this interest. As an investigator who has been involved in this evolutionary process from the beginning, simply because of being one of the investigators of the article which may have started it all, I feel a duty to bring deserved attention to the article which was omitted in the review.
BOOKRMEWS There are several texts devoted to either general pathology alone or both general and systemic pathology, which are either shorter than the standard reference textbooks or are in soft cover. The stated objectives of these books and their formats and styles vary greatly, and their usefulness will depend on the needs of the reader. Two recent soft-hound volumes address both general mechanisms of disease and the disorders of organ systems: Pathology. The Mechanisms of Disease, ed 2. Roderick A. Cawson, Alexander W. McCracken, Peter B. Marcus, et al. St Louis, MO, Mosby, 1989, 578 pages, $37.95. Pathology of Human Disease. John B. Walter. Philadelphia, PA, Lea & Febiger, 1989, 1,013 pages. Cawson et al devote somewhat more than a quarter of their book to general pathology, starting with a useful overview of normal cell biology and continuing with concise chapters on genetic and nutritional diseases and effects of physical a~ents before th~ traditional sections ~n inflammation, repair, and neoplasia, The chapters on diseases of the organ systems usually begin with a brief overview of pertinent anatomy and physiology, and include a summary of methods of clinical investigations of the system. The selection of disorders for discussion is not comprehensive but seems to be qu ite judicious. with appropriate attention to new information. There are well-chosen, sharply repro-
To the Editor:-I would like to thank Dr Min for his letter concerning our article on tubuloreticular structures (TRC) and cylindrical confronting cisternae (Ccq. We are aware of the contributions of Dr Min and his coworkers concerning TRS. We did not think it was possible to cite every article that had been published concerning TRS and CCC. I would like to point out that in reference 1 of our review article, Dr Min's article is cited as reference 10. I would also like to point out that in an article we published in the American Reviewof Respiratory Disease in 1983, we cited Dr Min's article as reference 17. In addition, reference 15 in our review article in Human Pathology cites an article by Drs Gyorkey, Sinkovics, Min, and coworkers published in 1972. We thought this article was somewhat of a review of the excellent work these investigators have done. We would like to apologize to Dr Min and colleagues for any misunderstanding that might have occurred as a result of our not citing their 1969 article directly. Again , we are certainly aware of the excellent work Dr Min and coworkers have done, and hope they will continue to add information to the literature concerning TRS and CCC. SAMUEL P. HAMMAR, MD Diagnostic Specialties Laboratory Bremerton, WA 98310
duced photographs and clear diagrams, and the limited number of selected references emphasizes recent reviews rather than primary sources. The authors state that the book is intended to enable a wide range of health care professionals who are newcomers to the field (including medical students) to gain an ideal of the scope of human disease without being overwhelmed by detail, and they have effectively met this goal. The larger book by Walter is intended to serve as a medical student text for the core material in the field of pathology. The first sections on cell and tissue damage, inflammation, and healing are rather detailed, with numerous diagrams. More than 100 pages are devoted to infections and parasitic infestations. In the organ system chapters, emphasis is appropriately placed on pathogenesis and morbid anatomy of selected major disorders. In addition, these chapters attempt to cover a number of the other less complex or rarer conditions in a large number of short sections, the treatment of many of which seems rather superficial. These sections perhaps make the scope of coverage too ambitious, and tend to put this book into unfortunate competition with the larger reference textbooks. The author acknowledges the use of many illustrations from his previous textbooks. The quality of these is not uniform. While many of the pictures are quite good, there are a few fuzzy photomicrographs. and some of the gross illustrations are too small to be fully effective. The selected references include important recent primary sources, reviews, other textbooks, and a large number of editorials. The choice of
1227
HUMAN PATHOLOGY
Volume 20. No. 12 (December 1989)
the title is a curious tautology, but the content may make this volume suitable for use with some pathology courses. Three shorter soft-cover volumes are in outline form, and are likely to be of more interest to someone seeking to review the subject than to a student new to the field: Pathology. ed 2. The National Medical Series for Independent Study. Virginia A. LiVolsi,John S.]. Brooks, Maria]. Merino, et al. New York, NY, Wiley, 1989, 534 pages. Key Facts in Pathology. Para Chandrasoma, Clive R. Taylor. New York , NY, Churchill-Livingstone, 1986, 445 pages . Aids to Pathology. M. F. Dixon. New York, NY, ChurchillLivingstone, 1985,322 pages. The authors of the first, and most comprehensive, of the books listed state that the book is intended to be used for review, not as a primary textbook. It includes several features designed to facilitate its use for this purpose, including a section on how to approach the National Board of Medical Examiners tests, and 500 board-type questions with thoroughly annotated answers. Although the text is in outline form, much of it is fleshed out into quite readable long phrases and complete sentences. The scope of coverage is generally comparable to the textbooks described above. The contents are very much up-to-date, but there are no references. The text is supplemented with several clear diagrams and a number of gross pictures and photomicrographs. The illustrations are generally quite wellreproduced, except for a few of the gross pictures which are too dark. This volume can certainly be recommended to students and others who want a detailed recall of the subject prior to taking a board type examination. The authors of the second volume set forth with a more ambitious objective, namely, to supply the basic information concerning the field of pathology needed by second-year medical students. The outline form is frequently expanded into phrases and sentences, and the text is accompan ied by clear diagrams and a selected number of photographs, some of which are not clear. Although the descriptive material about specific diseases is fairly comprehensive, the format seems poorly suited to a lucid presentation of pathogenesis, which puts this volume out of contention as a recommended primary text . There are no references. Although this book does not include study questions and annotated answers, it could be useful for purposes of review. The subject matter of the third volume is also presented in an outline form, but there is much less expanded text than in those books described above. There are a few tables and diagrams and no photographs. Selected references at the end of each chapter include reviews and some pr imary sources. Approximately two thirds of the book is devoted to general pathology, and the coverage of this area is somewhat more detailed than that of the organ systems which are presented in the barest factual outlines. Pathology. Understanding Human Disease, ed 2. Abner Golden , Deborah Powell, C. Darrell Jennings. Baltimore, MD, Williams & Wilkins, 1985, 568 pages, $31. The authors state that this book is intended to be one that can be read from cover to cover by students to provide perspective, understanding, and a sense that they have been introduced to the study of disease . A bit more than a quarter of the text deals with general mechanisms. The greater part of the remainder treats disorders by systems. In addition, there is a chapter on pediatric disorders and a section that surveys the use of the clinical laboratory with
specific attention to many of the most important tests. The text is lucid, and the choice of topics for inclusion seems apt. References are primarily selected reviews. There is no attempt to "cover" each system by superficial treatment of the generally less common diseases that are otherwise omitted. On the whole, more space and greater emphasis are given to pathogenesis than to description of lesions. The gross illustrations and photomicrographs are numerous and exceptional in the consistency of their high quality. The generous use of these excellent illustrations of the actual lesions is a refreshing contrast to the proliferation of drawings in some other new textbooks that may suggest that medical students or even pathologists no longer really need to look at organs or slides. This volume certainly seems suited to meet its objectives. Indeed, the scope and contents probably much more realistically reflect what medical students should be expected to comprehend than the contents of the "standard " textbooks. On the other hand, the need to refer to a source with more detail cannot be met by this book, and that is likely to reduce its appeal as a recommended course text. Two soft bound volumes are devoted to general pathology only: Essentials of General Pathology. John R. Warren, Dante G. Scarpelli,janardan K. Reddy, etal. New York, NY, Macmillan , 1987,259 pages. An Introduction to Disease. F. Stephen Vogel. Chicago, IL, Field , Rich & Associates, 1985, 248 pages. The first of these is intended to serve as an introductory text in general pathology for students in the biomedical sciences. In six chapters, the authors discuss inflammation , repair, cell injury, immunologic d isorders, and neoplasia in considerable detail, with emphasis on biochemical and molecular biologic mechanisms. The discussion of a few of the specific diseases chosen to illustrate these general topics, particularly in the section on infections, is comparable to the corresponding sections in texts of systemic pathology. Tables and diagrams are abundant, and the numerous gross and microscopic photographs are technical1y of high quality, even though many of them are very small. There are numerous references to contemporary, primary sources at the end of each chapter. This volume seems apt as a basic text for a course limited to general pathology and may also be useful to others seeking to update their understanding of basic disease mechanisms. Ostensibly, the volume by Vogel has a similar scope and objective to that of Warren et al, but there is an entirely different style and a greater emphasis on the "big picture" than on the finer points of molecular pathophysiology. The book is lavishly il\ustrated with excellent reproductions of gross pictures and sharp photomicrographs that fill half or more of the pages. An unusual feature is the inclusion of considerable clinical data in the captions . It is no surprise that this distinguished neuropathologist has chosen so many illustrations of the brain, but these effectively convey basic processes rather than specific details of neuropathology. This book strongly projects a point of view, and the writing has a personal style that may appeal less to some readers than to this one. While it is unlikely that many course directors would consider this to be an appropriate basic source text for medical students, it certainly provides a thought-provoking, and even entertaining, up-to-date overview for a more general readership.e-Ozoacs F. GRAY, MD, Professor of Pathology, Vanderbilt University, Nashville, TN.
1228