- Email: [email protected]
The first cytopathology atlas
Journal of the American Society of Cytopathology (2015) 4, 53e56
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.jascyto.org/
COMMENTARY
The first cytopathology atlas Steven I. Hajdu, MDa,*, Syed Z. Ali, MDb a b
Pathology Consultants, 1759 Drumcliff Court, Westlake Village, California Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
Herman Lebert (1813-1878), a native of Breslau, on the Oder River between Poland and Germany, was in medical school, when in Berlin, Theodor Schwann (1810-1882) and Johannes Muller (1801-1858) established the cell theory in 1838. After graduation, Lebert attempted to become a clinical practitioner in Germany and failed. He did not have the support of a renowned mentor and was a Jew. He ended up taking whatever job was available to earn a living and became an itinerant pathologist. He was doing everything that had to be done from autopsies to staining and counting cells. His restless mind, obsessive drive, and scientific curiosity led him first to Paris and then Switzerland. While in Paris, he learned about Alexander Donne (1801-1878) and his associates’ cytology activities and publications. With determination and hard work, he began collecting and photographing his microscopic smear preparations by the newly invented Daguerre technique. He prepared the smears with acetic acid for transparency and diluted iodine for color. His microscopic preparations came from scrapings, imprints, and aspirates of benign and malignant pathological lesions, secretions, and body fluids. Being familiar with publications of pioneers in clinical medicine and pathology, Lebert felt that the time was right to publish his collection of photomicrographs. His atlas of 22 full-page plates with 249 figures and 49 pages of legends was added as a third volume to his 2-volume textbook (Fig. 1).1
*Corresponding author: Steven I. Hajdu, MD, Pathology Consultants, 1759 Drumcliff Court, Westlake Village, CA 91361; Tel.: (805) 496-0691. E-mail address: [email protected] (S.I. Hajdu).
Figure 1
2213-2945/$36 Ó 2015 American Society of Cytopathology. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jasc.2014.09.209
Title page of Lebert’s atlas.
54
S.I. Hajdu, S.Z. Ali
Figure 2 Plate 20 of Lebert’s atlas. Fig. 1, Squamous cancer cells of the uterine cervix. Figs. 2 to 6, Single cells and tissue fragment of esophageal squamous carcinoma (Fig. 5 shows bacilli from an ulcerated area). Fig. 7, Cancer cells invading fibrous tissue. Figs. 8 and 9, Tissue fragment and single cells from gastric carcinoma. Fig. 10, Gastric carcinoma metastatic to the liver.
Lebert made numerous first observations, and his photomicrographs represent the earliest compilation of benign and malignant cells. The most notable illustrations in the atlas of non-neoplastic lesions are abscesses of the brain and liver, tuberculous lymphadenitis and granulomas, ulcers of the stomach and colon, melanosis coli, echinococcus in the liver
(with hooklets and all), and ciliated and metaplastic respiratory epithelial cells, and buccal mucosal cells in sputum. The figures of benign tumors include cells from squamous papilloma and condyloma, fibroadenoma and phyllodes tumor of the breast, pulmonary chondroid hamartoma, chondromatosis of the fingers, meningioma, uterine fibroid,
The first cytopathology atlas
55
Figure 3 Plate 21 of Lebert’s atlas. Figs. 1 to 3, Cancer cells from hepatic metastases of pyloric carcinoma. Fig. 4, Cancer cells from pulmonary metastasis of gastric carcinoma. Figs. 5 to 7, Single cells and tissue fragment of colloid carcinoma of the colon. Figs. 8 to 10, Tissue fragment and single cells of carcinoma of the maxillary antrum.
dermatofibroma, villonodular synovitis, lipoma, and dermoid cysts of the ovary. Among the illustrations of cytologic preparations from malignant neoplasms are squamous carcinoma of the uterine cervix, buccal mucosa, maxillary antrum, esophagus, and the
lung. Adenocarcinomas are represented by breast carcinoma, primary and metastatic carcinoma of the stomach and colon, endometrial carcinoma, and carcinoma of the ovary. He also illustrated seminoma of the testis, spindle cell sarcoma of the uterus, and fibrous soft tissue sarcoma (Figs. 2 and 3).
56 Lebert demonstrated that there are many different microscopic forms of cancer, even in the same organ, and that cancer cells are distinctly different from benign cells. He illustrated enlarged nuclei, macronucleoli, multiple nuclei, and increased nucleocytoplasmic ratio as hallmarks of cancer cells. He gave the name “myeloid tumor” to neoplasms that were composed of marrow-like cells. He stressed the importance of microscopic examination of every pathologic specimen and warned that the cytologic examination was not only time-consuming, but for the uninitiated it can be difficult to separate the wheat from the chaff. Above all, he felt, everybody is his own teacher. Lebert published an enlarged new edition of his cytology atlas a few years later, and in 1851, he wrote a comprehensive clinical and pathologic treatise on cancer.2 In 1857, he summarized his thoughts and all that was
S.I. Hajdu, S.Z. Ali known about anatomic and clinical pathology in a text in 2 volumes.3 Taken together, it can surely be said with confidence that Lebert was not only a pioneer microscopic pathologist par excellence, but also that he enriched the understanding and importance of cytologic examination for generations to come by crafting such a painstakingly detailed atlas.
References 1. Lebert H. Physiologie Pathologique ou Recherches Clinique, Experimentales et Microscopique. Paris, France: Bailliere; 1845. 2. Lebert H. Traite Pratique des Maladies Cancereuses et des Affections Curables Confondues avec le Cancer. Paris, France: Bailliere; 1851. 3. Lebert H. Traite d’Anatomie Pathologique General et Special. Paris, France: Bailliere; 1857.
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.jascyto.org/
COMMENTARY
The first cytopathology atlas Steven I. Hajdu, MDa,*, Syed Z. Ali, MDb a b
Pathology Consultants, 1759 Drumcliff Court, Westlake Village, California Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
Herman Lebert (1813-1878), a native of Breslau, on the Oder River between Poland and Germany, was in medical school, when in Berlin, Theodor Schwann (1810-1882) and Johannes Muller (1801-1858) established the cell theory in 1838. After graduation, Lebert attempted to become a clinical practitioner in Germany and failed. He did not have the support of a renowned mentor and was a Jew. He ended up taking whatever job was available to earn a living and became an itinerant pathologist. He was doing everything that had to be done from autopsies to staining and counting cells. His restless mind, obsessive drive, and scientific curiosity led him first to Paris and then Switzerland. While in Paris, he learned about Alexander Donne (1801-1878) and his associates’ cytology activities and publications. With determination and hard work, he began collecting and photographing his microscopic smear preparations by the newly invented Daguerre technique. He prepared the smears with acetic acid for transparency and diluted iodine for color. His microscopic preparations came from scrapings, imprints, and aspirates of benign and malignant pathological lesions, secretions, and body fluids. Being familiar with publications of pioneers in clinical medicine and pathology, Lebert felt that the time was right to publish his collection of photomicrographs. His atlas of 22 full-page plates with 249 figures and 49 pages of legends was added as a third volume to his 2-volume textbook (Fig. 1).1
*Corresponding author: Steven I. Hajdu, MD, Pathology Consultants, 1759 Drumcliff Court, Westlake Village, CA 91361; Tel.: (805) 496-0691. E-mail address: [email protected] (S.I. Hajdu).
Figure 1
2213-2945/$36 Ó 2015 American Society of Cytopathology. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jasc.2014.09.209
Title page of Lebert’s atlas.
54
S.I. Hajdu, S.Z. Ali
Figure 2 Plate 20 of Lebert’s atlas. Fig. 1, Squamous cancer cells of the uterine cervix. Figs. 2 to 6, Single cells and tissue fragment of esophageal squamous carcinoma (Fig. 5 shows bacilli from an ulcerated area). Fig. 7, Cancer cells invading fibrous tissue. Figs. 8 and 9, Tissue fragment and single cells from gastric carcinoma. Fig. 10, Gastric carcinoma metastatic to the liver.
Lebert made numerous first observations, and his photomicrographs represent the earliest compilation of benign and malignant cells. The most notable illustrations in the atlas of non-neoplastic lesions are abscesses of the brain and liver, tuberculous lymphadenitis and granulomas, ulcers of the stomach and colon, melanosis coli, echinococcus in the liver
(with hooklets and all), and ciliated and metaplastic respiratory epithelial cells, and buccal mucosal cells in sputum. The figures of benign tumors include cells from squamous papilloma and condyloma, fibroadenoma and phyllodes tumor of the breast, pulmonary chondroid hamartoma, chondromatosis of the fingers, meningioma, uterine fibroid,
The first cytopathology atlas
55
Figure 3 Plate 21 of Lebert’s atlas. Figs. 1 to 3, Cancer cells from hepatic metastases of pyloric carcinoma. Fig. 4, Cancer cells from pulmonary metastasis of gastric carcinoma. Figs. 5 to 7, Single cells and tissue fragment of colloid carcinoma of the colon. Figs. 8 to 10, Tissue fragment and single cells of carcinoma of the maxillary antrum.
dermatofibroma, villonodular synovitis, lipoma, and dermoid cysts of the ovary. Among the illustrations of cytologic preparations from malignant neoplasms are squamous carcinoma of the uterine cervix, buccal mucosa, maxillary antrum, esophagus, and the
lung. Adenocarcinomas are represented by breast carcinoma, primary and metastatic carcinoma of the stomach and colon, endometrial carcinoma, and carcinoma of the ovary. He also illustrated seminoma of the testis, spindle cell sarcoma of the uterus, and fibrous soft tissue sarcoma (Figs. 2 and 3).
56 Lebert demonstrated that there are many different microscopic forms of cancer, even in the same organ, and that cancer cells are distinctly different from benign cells. He illustrated enlarged nuclei, macronucleoli, multiple nuclei, and increased nucleocytoplasmic ratio as hallmarks of cancer cells. He gave the name “myeloid tumor” to neoplasms that were composed of marrow-like cells. He stressed the importance of microscopic examination of every pathologic specimen and warned that the cytologic examination was not only time-consuming, but for the uninitiated it can be difficult to separate the wheat from the chaff. Above all, he felt, everybody is his own teacher. Lebert published an enlarged new edition of his cytology atlas a few years later, and in 1851, he wrote a comprehensive clinical and pathologic treatise on cancer.2 In 1857, he summarized his thoughts and all that was
S.I. Hajdu, S.Z. Ali known about anatomic and clinical pathology in a text in 2 volumes.3 Taken together, it can surely be said with confidence that Lebert was not only a pioneer microscopic pathologist par excellence, but also that he enriched the understanding and importance of cytologic examination for generations to come by crafting such a painstakingly detailed atlas.
References 1. Lebert H. Physiologie Pathologique ou Recherches Clinique, Experimentales et Microscopique. Paris, France: Bailliere; 1845. 2. Lebert H. Traite Pratique des Maladies Cancereuses et des Affections Curables Confondues avec le Cancer. Paris, France: Bailliere; 1851. 3. Lebert H. Traite d’Anatomie Pathologique General et Special. Paris, France: Bailliere; 1857.