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Scientific basis of transfusion medicine: Implications for clinical practice
HUMAN PATHOLOGY
Volume 26, No, 3 (March 1995)
CLARA SAMBADE, MD MANUEL SOBRINHO-SIMOES, MD D e p a r t m e n t of Pathology Porto Medical School Porto, Spain JAVIER P. VILLANUEVA,MD D e p a r t m e n t of Pathology Hospital General Vigo, Spain 1. Cameselle-TeijeiroJ,Varela-DurfinJ,Sambade C, et al: Solid cell nests of the thyroid: Light microscopyand immunohistochemieal profile. HUMPATHOL 25:684-693, 1994 2. Williams ED, Toyn CE, Harach HR: The ultimobranchial body and congenital thyroid abnormalities in man. J Pathol 159:135-141, 1989 3. Puebtitz S, Weinberg AG, Albores-SaavedraJ: Thyroid C cells in the DiGeorge anomaly. A quantitative study. Pediatr Patbol 13:463-373, 1993
BOOK REVIEWS Diagnostic Surgical Pathology (ed 2, a two-volume set). Step h e n S. Sternberg (ed) and Donald A. Antonioli, Darryl Carter, Stacey E. Mills, and H a r o l d A. O b e r m a n (associate eds). New York, NY, Raven, 1993, 2,474 pp, $325. I was educated on a single textbook of diagnostic surgical pathology. Until recently I had n o t seriously e x p l o r e d the newer generation of diagnostic surgical pathology textbooks. In the process of reviewing this textbook, it was a very pleasant surprise to find out how useful and organized it was. In the preface to the first edition, the authors state that they "att e m p t e d to emphasize differential diagnosis of the surgical s p e c i m e n , " and they have c o n t i n u e d that emphasis in the second edition. T h e two-volume b o o k is divided into 10 major areas (skin, soft tissue, b o n e and joints; breast; central nervous system; e n d o c r i n e system; h e m a t o p o i e t i c and lymphatic systems; head and neck; intrathoracic organs and blood vessels; alimentary can al and associated organs; urinary tract and male genital system; female reproductive system and p e r i t o n e u m ) , and there are a total of 55 chapters. T h e 80 authors include a veritable " w h o ' s w h o " of diagnostic surgical pathology. • T h e r e is a liberal use o f p r e d o m i n a n t l y quarter- to halfpage black and white p h o t o m i c r o g r a p h s with colored photomicrographs scattered t h r o u g h o u t all the chapters. In fact, there are m o r e than 2,300 gross and histological photographs with m o r e than 1,200 in color. H a l f of these illustrations are new to the second edition. In some chapters o n e can occasionally question why a particular p h o t o g r a p h was shown in color and a n o t h e r was n o t (eg, r h e u m a t o i d n o d u l e v gout). It is a nice touch that in the chapter on melanocytic lesions, where color p h o t o m i c r o g r a p h s are very helpful, every p h o t o g r a p h is in color. Some of the gross p h o t o g r a p h s are truly spectacular. For a b o o k of this size with a very large n u m b e r of photographs, there are remarkably few that are of less than adequate quality. Each chapter has extensive current references. Some chapters, such as that on neoplasms of the skin, make g o o d use of flow charts to p o i n t out the distinguishing features of various tumors. Most of the chapters appropriately use tables with legible type. A m i n o r disadvantage is that some of the charts necessitate turning the b o o k 90°; however, this arrangem e n t results in the m o r e extensive tables having legible type.
356
4. Sobrinho-SimoesM, Nesland JM, Johannessen JV: Farewell to the dual histogenesis of thyroid tumours. Ultrastruct Pathol 8:iii-v,1985 5. Holm R, Sobrinho-SimoesM, Nesland J, et al: Medullary thyroid carcinoma with thyrogl0bulin immunoreactivity:A special entity? Lab Invest 57:258268, 1987 6. Sambade C, Sobrinho-SimoesM: Implications des donn~es de la microscopie electronique et de rimmuno-tumeurs "mixtes" de la thyroide. Arch Anat Cytol Pathol 37:15-18, 1989 7. Cameselle-TeijeiroJ:Clinicopathologic,ultrastructural and immunohistochemical study of thyroid cancer in the south of Galicia (Spain). Doctoral thesis, Universityof Santiago, Spain, 1990 8. Sobrinho-SimoesM: Mixed medullary and follicular carcinoma of the thyroid. Histopathology 23:28%289, 1993 9. Sugiyama S: The embryology of the human thyroid gland including ultimobranchial body and other related. Ergeb Anat Entwickl Gesch 44:3-111, 1971 10. CameseUe-TeijeiroJ, Varela-Durfin J: Carcinomas de tiroides. Propuesta de una teoria histogen6tica unitaria. Patolog[a 27:53-61, 1994 11. Ozaki O, Ito K, Sugino K, et al: Solid cell nests of the thyroid gland. Virchows Arch A Pathol Anat Histopathol 418:201-205, 1991 12. Cameselle-TeijeiroJ, Sambade C, Varela-DurfinJ, et al: Carcinomas of the thyroid. Is there room for a single histogenesis?. Patologia 25:75-76, 1992 (abstr)
I n c l u d e d in some chapters, such as that on disorders of soft tissue, is a discussion of a philosophical approach to the troublesome lesions. T h e inclusion of practical helpful hints on the h a n d l i n g of specimens, such as in the chapter on b o n e tumors, is a nice addition. Most authors include, where appropriate, a discussion of newer diagnostic techniques, including cytogenetics and immunohistochemistry. In some instances (eg, soft tissue and breast), there is a discussion of the features that should be i n c l u d e d in the pathology report. These are helpful in an age of rapidly changing expectations and legal responsibilities. Each chapter covers the c o m m o n lesions and a very high percentage of the u n c o m m o n ones. Most of the chapters have minimal to no discussion of therapy, which is a drawback for the pathologist who is looking for a one-stop reference before attending t u m o r board. T h e editors state in the preface to their first edition that their authors were chosen n o t only for their knowledge but also for their "skill in written c o m m u n i c a t i o n . " For such a diversity of authors, one can o p e n to virtually any chapter to find the material presented in a concise, understandable m a n n e r . In many, in fact, the tone almost approaches that of having a conversation with a colleague as the differential points are discussed. T h e ultimate test of a textbook of diagnostic surgical pathology is its usefulness in everyday practice. For several m o n t h s this was the textbook I used first for any question when I was signing out. It never failed m e and has e a r n e d "its place adjacent to the microscope," as stated in the editors' preface. I highly r e c o m m e n d this very useful b o o k to both trainees and practitioners of diagnostic surgical patholOgy.--KAREN IRELAND, MD, Department of Pathology, Oregon
Health Sciences University, Portland, OR_ Scientific Basis of Transfusion Medicine: Implications for Clinical Practice. I~ C. A n d e r s o n and P. M. Ness (eds). Philadelphia, PA, Saunders, 1994, 929 pages, $128.25. This text exemplifies the essence of transfusion medicine. Drawing u p o n the disciplines of hematology, i m m u n o l ogy, m o l e c u l a r g e n e t i c s , coagulation, transplantation, epidemiology, and biochemistry, the authors and editors have created a superlative text that integrates advances in these
BOOK REVIEWS
diverse fields to convey the scientific basis for rational and safe transfusion practice. The text is divided into 11 sections. The first section on hematopoiesis consists of four chapters reviewing the influence of molecular genetics and growth factors on our understanding of erythropoiesis, granulopoiesis, and thrombocytopoiesis. A concise review of the organization of the hematopoietic progenitor cell compartment and the mechanisms involved in the regulation of hematopoietic cell production by the colony-stimulatingfactors (CSFs) provides insight into strategies for future manipulation of bone marrow function. It is followed by a section consisting of four up-to-date chapters on immunology and genetics. The complexities of antigen recognition, T-cell activation, the structure and function of the T-cell antigen receptor/signal transducing complex, and the role of accessory/adhesion molecules are condensed in the chapter on cellular immunity. The review of humoral immunity includes discussion of B-cell development, growth, and differentiation; surface immunoglobulin (lg) receptor complex and signal transduction; non-Ig surface molecules (CD markers) expressed during B-cell differentiation; and T-cell-dependent and - i n d e p e n d e n t activation of B cells. The contribution of molecular biology to our understanding of the complement system and transfusion genetics enhances this review. The next four sections of the text are devoted to red cells, granulocytes, platelets, and plasma proteins, respectively. The chapters within each of these sections do not deal with typical transfusion issues, such as dose for administration or technically related blood banking issues. Rather, the emphasis is on membrane structure, cell metabolism, and function during storage, serological, and molecular characterization of surface antigens, and the role of adhesion proteins in intercellular interactions. Clinical disorders involving granulocyte and platelet alloantibodies also are reviewed. The section on plasma proteins includes a review of the biochemistry of plasma proteins with summary tables of their gene nomenclature and chromosomal localization as well as chapters on hemostasis and fibrinolysis. Guidelines for the use of selected thrombolytic and antifibrinolytic agents are summarized. The final chapter in this section is an overview of the use in transfusion practice of plasma proteins, including fresh frozen plasma, immune globulins, and a diverse group of factor concentrates.
The section devoted to intrauterine and neonatal transfusions is highlighted by a chapter on our evolving understanding of neonatal immunobiology and, more specifically, the immune response of the neonate to blood transfusion. A section on transplantation contains an overview of transplantation immunology, including a brief discussion on the major histocompatibility complex, which sets the stage for subsequent discussion on the transplantation of bone marrow, peripheral blood stem cells, and umbilical cord stem cells. The immune effects of transfusion section includes such topics as alloimmunization to blood group and platelet antigens, transfusion-associated graft-versus-host disease, and transfusion-associated immunomodulation. Inciting immune factors, methods of prevention, techniques to modify transfused blood products to reduce or eliminate the inciting factor, and therapeutic modalities are discussed. Summary chapters on hepatitis, cytomegalovirus, and h u m a n immunodeficiency viruses are included in the section on transfusion-transmitted diseases. The final section of this text is dedicated to diagnostic technologies that are applied to transfusion practice. Topics include the principles of the immunoassay, cell survival, flow cytometry, molecular biology, the polymerase chain reaction, and cloning techniques. The final topics comprise heterogeneous therapeutic technologies that are applied to transfusion practice and include the principles of apheresis, alternatives to homologous transfusion, use of red cell substitutes, erythropoietin and CSFs, and the use of gene therapy. The current status of viral inactivation of various blood products also is addressed. The editors and authors have masterfully achieved a remarkably current and comprehensive text that encompasses heterogeneous fields of basic scientific investigation and successfully integrates the information to manage patients who require transfusion. They provide valuable insight into the emerging therapeutic strategies that will have direct impact on transfusion practices of the future. The text is essential for physicians who specialize in transfusion medicine and residents who are training in pathology. It is highly recommended for physicians of all specialties who care for patients who require transfusion.--ELAINE K. JETER, MD, Department
BOOKS RECEIVED
Extranodal Lymphomas. P. G. Isaacson and A. J. Norton. New York,
Drug-Induced Liver Disease. Geoffrey C. Farrell. New York, NY,
Pathology of the Lung (ed 2). William M. Thurlbeck and Andrew
Churchill Livingstone, 1994, 673 pages, $149.95. Manual of Histological Techniques and Their Diagnostic Application.
J. D. Bancroft. New York, NY, Churchill Livingstone, 1994, 457 pages, $45. Hematology--Basic Principles and Practice (ed 2). Ronald Hoffman,
of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC.
NY, Churchill Livingstone, 340 pages, $180. Churg. New York, NY, Churchill Livingstone, 1,178 pages, $199. Diagnostic Immunopathology (ed 2). Robert B. Colvin, Atul K. Bhan, and Robert T. McCluskey. New York, NY, Raven, 842 pages, $235.
Edward J. Benz, Sanford J. Shatfil, et al (eds). New York, NY, Churchill Livingstone, 2,369 pages, $169.95.
Tumors of the Kidney, Bladder, and Related Urinary Structures-Atlas of Tumor Pathology: Third Series, Fascicle 11. William M.
Principles and Practice of Infectious Disease (ed 4). Gerald L. Mandell, John E. Bennett, and Raphael Dolin (eds). New York, NY,
Murphy, J. Bruce Beckwith, and George M. Farrow. Washington, DC, Armed Forces Institute of Pathology, 326 pages, $55 plus $4 shipping and handling.
Churchill Livingstone, 1,312 pages, $249.95.
357
Volume 26, No, 3 (March 1995)
CLARA SAMBADE, MD MANUEL SOBRINHO-SIMOES, MD D e p a r t m e n t of Pathology Porto Medical School Porto, Spain JAVIER P. VILLANUEVA,MD D e p a r t m e n t of Pathology Hospital General Vigo, Spain 1. Cameselle-TeijeiroJ,Varela-DurfinJ,Sambade C, et al: Solid cell nests of the thyroid: Light microscopyand immunohistochemieal profile. HUMPATHOL 25:684-693, 1994 2. Williams ED, Toyn CE, Harach HR: The ultimobranchial body and congenital thyroid abnormalities in man. J Pathol 159:135-141, 1989 3. Puebtitz S, Weinberg AG, Albores-SaavedraJ: Thyroid C cells in the DiGeorge anomaly. A quantitative study. Pediatr Patbol 13:463-373, 1993
BOOK REVIEWS Diagnostic Surgical Pathology (ed 2, a two-volume set). Step h e n S. Sternberg (ed) and Donald A. Antonioli, Darryl Carter, Stacey E. Mills, and H a r o l d A. O b e r m a n (associate eds). New York, NY, Raven, 1993, 2,474 pp, $325. I was educated on a single textbook of diagnostic surgical pathology. Until recently I had n o t seriously e x p l o r e d the newer generation of diagnostic surgical pathology textbooks. In the process of reviewing this textbook, it was a very pleasant surprise to find out how useful and organized it was. In the preface to the first edition, the authors state that they "att e m p t e d to emphasize differential diagnosis of the surgical s p e c i m e n , " and they have c o n t i n u e d that emphasis in the second edition. T h e two-volume b o o k is divided into 10 major areas (skin, soft tissue, b o n e and joints; breast; central nervous system; e n d o c r i n e system; h e m a t o p o i e t i c and lymphatic systems; head and neck; intrathoracic organs and blood vessels; alimentary can al and associated organs; urinary tract and male genital system; female reproductive system and p e r i t o n e u m ) , and there are a total of 55 chapters. T h e 80 authors include a veritable " w h o ' s w h o " of diagnostic surgical pathology. • T h e r e is a liberal use o f p r e d o m i n a n t l y quarter- to halfpage black and white p h o t o m i c r o g r a p h s with colored photomicrographs scattered t h r o u g h o u t all the chapters. In fact, there are m o r e than 2,300 gross and histological photographs with m o r e than 1,200 in color. H a l f of these illustrations are new to the second edition. In some chapters o n e can occasionally question why a particular p h o t o g r a p h was shown in color and a n o t h e r was n o t (eg, r h e u m a t o i d n o d u l e v gout). It is a nice touch that in the chapter on melanocytic lesions, where color p h o t o m i c r o g r a p h s are very helpful, every p h o t o g r a p h is in color. Some of the gross p h o t o g r a p h s are truly spectacular. For a b o o k of this size with a very large n u m b e r of photographs, there are remarkably few that are of less than adequate quality. Each chapter has extensive current references. Some chapters, such as that on neoplasms of the skin, make g o o d use of flow charts to p o i n t out the distinguishing features of various tumors. Most of the chapters appropriately use tables with legible type. A m i n o r disadvantage is that some of the charts necessitate turning the b o o k 90°; however, this arrangem e n t results in the m o r e extensive tables having legible type.
356
4. Sobrinho-SimoesM, Nesland JM, Johannessen JV: Farewell to the dual histogenesis of thyroid tumours. Ultrastruct Pathol 8:iii-v,1985 5. Holm R, Sobrinho-SimoesM, Nesland J, et al: Medullary thyroid carcinoma with thyrogl0bulin immunoreactivity:A special entity? Lab Invest 57:258268, 1987 6. Sambade C, Sobrinho-SimoesM: Implications des donn~es de la microscopie electronique et de rimmuno-tumeurs "mixtes" de la thyroide. Arch Anat Cytol Pathol 37:15-18, 1989 7. Cameselle-TeijeiroJ:Clinicopathologic,ultrastructural and immunohistochemical study of thyroid cancer in the south of Galicia (Spain). Doctoral thesis, Universityof Santiago, Spain, 1990 8. Sobrinho-SimoesM: Mixed medullary and follicular carcinoma of the thyroid. Histopathology 23:28%289, 1993 9. Sugiyama S: The embryology of the human thyroid gland including ultimobranchial body and other related. Ergeb Anat Entwickl Gesch 44:3-111, 1971 10. CameseUe-TeijeiroJ, Varela-Durfin J: Carcinomas de tiroides. Propuesta de una teoria histogen6tica unitaria. Patolog[a 27:53-61, 1994 11. Ozaki O, Ito K, Sugino K, et al: Solid cell nests of the thyroid gland. Virchows Arch A Pathol Anat Histopathol 418:201-205, 1991 12. Cameselle-TeijeiroJ, Sambade C, Varela-DurfinJ, et al: Carcinomas of the thyroid. Is there room for a single histogenesis?. Patologia 25:75-76, 1992 (abstr)
I n c l u d e d in some chapters, such as that on disorders of soft tissue, is a discussion of a philosophical approach to the troublesome lesions. T h e inclusion of practical helpful hints on the h a n d l i n g of specimens, such as in the chapter on b o n e tumors, is a nice addition. Most authors include, where appropriate, a discussion of newer diagnostic techniques, including cytogenetics and immunohistochemistry. In some instances (eg, soft tissue and breast), there is a discussion of the features that should be i n c l u d e d in the pathology report. These are helpful in an age of rapidly changing expectations and legal responsibilities. Each chapter covers the c o m m o n lesions and a very high percentage of the u n c o m m o n ones. Most of the chapters have minimal to no discussion of therapy, which is a drawback for the pathologist who is looking for a one-stop reference before attending t u m o r board. T h e editors state in the preface to their first edition that their authors were chosen n o t only for their knowledge but also for their "skill in written c o m m u n i c a t i o n . " For such a diversity of authors, one can o p e n to virtually any chapter to find the material presented in a concise, understandable m a n n e r . In many, in fact, the tone almost approaches that of having a conversation with a colleague as the differential points are discussed. T h e ultimate test of a textbook of diagnostic surgical pathology is its usefulness in everyday practice. For several m o n t h s this was the textbook I used first for any question when I was signing out. It never failed m e and has e a r n e d "its place adjacent to the microscope," as stated in the editors' preface. I highly r e c o m m e n d this very useful b o o k to both trainees and practitioners of diagnostic surgical patholOgy.--KAREN IRELAND, MD, Department of Pathology, Oregon
Health Sciences University, Portland, OR_ Scientific Basis of Transfusion Medicine: Implications for Clinical Practice. I~ C. A n d e r s o n and P. M. Ness (eds). Philadelphia, PA, Saunders, 1994, 929 pages, $128.25. This text exemplifies the essence of transfusion medicine. Drawing u p o n the disciplines of hematology, i m m u n o l ogy, m o l e c u l a r g e n e t i c s , coagulation, transplantation, epidemiology, and biochemistry, the authors and editors have created a superlative text that integrates advances in these
BOOK REVIEWS
diverse fields to convey the scientific basis for rational and safe transfusion practice. The text is divided into 11 sections. The first section on hematopoiesis consists of four chapters reviewing the influence of molecular genetics and growth factors on our understanding of erythropoiesis, granulopoiesis, and thrombocytopoiesis. A concise review of the organization of the hematopoietic progenitor cell compartment and the mechanisms involved in the regulation of hematopoietic cell production by the colony-stimulatingfactors (CSFs) provides insight into strategies for future manipulation of bone marrow function. It is followed by a section consisting of four up-to-date chapters on immunology and genetics. The complexities of antigen recognition, T-cell activation, the structure and function of the T-cell antigen receptor/signal transducing complex, and the role of accessory/adhesion molecules are condensed in the chapter on cellular immunity. The review of humoral immunity includes discussion of B-cell development, growth, and differentiation; surface immunoglobulin (lg) receptor complex and signal transduction; non-Ig surface molecules (CD markers) expressed during B-cell differentiation; and T-cell-dependent and - i n d e p e n d e n t activation of B cells. The contribution of molecular biology to our understanding of the complement system and transfusion genetics enhances this review. The next four sections of the text are devoted to red cells, granulocytes, platelets, and plasma proteins, respectively. The chapters within each of these sections do not deal with typical transfusion issues, such as dose for administration or technically related blood banking issues. Rather, the emphasis is on membrane structure, cell metabolism, and function during storage, serological, and molecular characterization of surface antigens, and the role of adhesion proteins in intercellular interactions. Clinical disorders involving granulocyte and platelet alloantibodies also are reviewed. The section on plasma proteins includes a review of the biochemistry of plasma proteins with summary tables of their gene nomenclature and chromosomal localization as well as chapters on hemostasis and fibrinolysis. Guidelines for the use of selected thrombolytic and antifibrinolytic agents are summarized. The final chapter in this section is an overview of the use in transfusion practice of plasma proteins, including fresh frozen plasma, immune globulins, and a diverse group of factor concentrates.
The section devoted to intrauterine and neonatal transfusions is highlighted by a chapter on our evolving understanding of neonatal immunobiology and, more specifically, the immune response of the neonate to blood transfusion. A section on transplantation contains an overview of transplantation immunology, including a brief discussion on the major histocompatibility complex, which sets the stage for subsequent discussion on the transplantation of bone marrow, peripheral blood stem cells, and umbilical cord stem cells. The immune effects of transfusion section includes such topics as alloimmunization to blood group and platelet antigens, transfusion-associated graft-versus-host disease, and transfusion-associated immunomodulation. Inciting immune factors, methods of prevention, techniques to modify transfused blood products to reduce or eliminate the inciting factor, and therapeutic modalities are discussed. Summary chapters on hepatitis, cytomegalovirus, and h u m a n immunodeficiency viruses are included in the section on transfusion-transmitted diseases. The final section of this text is dedicated to diagnostic technologies that are applied to transfusion practice. Topics include the principles of the immunoassay, cell survival, flow cytometry, molecular biology, the polymerase chain reaction, and cloning techniques. The final topics comprise heterogeneous therapeutic technologies that are applied to transfusion practice and include the principles of apheresis, alternatives to homologous transfusion, use of red cell substitutes, erythropoietin and CSFs, and the use of gene therapy. The current status of viral inactivation of various blood products also is addressed. The editors and authors have masterfully achieved a remarkably current and comprehensive text that encompasses heterogeneous fields of basic scientific investigation and successfully integrates the information to manage patients who require transfusion. They provide valuable insight into the emerging therapeutic strategies that will have direct impact on transfusion practices of the future. The text is essential for physicians who specialize in transfusion medicine and residents who are training in pathology. It is highly recommended for physicians of all specialties who care for patients who require transfusion.--ELAINE K. JETER, MD, Department
BOOKS RECEIVED
Extranodal Lymphomas. P. G. Isaacson and A. J. Norton. New York,
Drug-Induced Liver Disease. Geoffrey C. Farrell. New York, NY,
Pathology of the Lung (ed 2). William M. Thurlbeck and Andrew
Churchill Livingstone, 1994, 673 pages, $149.95. Manual of Histological Techniques and Their Diagnostic Application.
J. D. Bancroft. New York, NY, Churchill Livingstone, 1994, 457 pages, $45. Hematology--Basic Principles and Practice (ed 2). Ronald Hoffman,
of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC.
NY, Churchill Livingstone, 340 pages, $180. Churg. New York, NY, Churchill Livingstone, 1,178 pages, $199. Diagnostic Immunopathology (ed 2). Robert B. Colvin, Atul K. Bhan, and Robert T. McCluskey. New York, NY, Raven, 842 pages, $235.
Edward J. Benz, Sanford J. Shatfil, et al (eds). New York, NY, Churchill Livingstone, 2,369 pages, $169.95.
Tumors of the Kidney, Bladder, and Related Urinary Structures-Atlas of Tumor Pathology: Third Series, Fascicle 11. William M.
Principles and Practice of Infectious Disease (ed 4). Gerald L. Mandell, John E. Bennett, and Raphael Dolin (eds). New York, NY,
Murphy, J. Bruce Beckwith, and George M. Farrow. Washington, DC, Armed Forces Institute of Pathology, 326 pages, $55 plus $4 shipping and handling.
Churchill Livingstone, 1,312 pages, $249.95.
357