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Thurlbeck’s Pathology of the Lung: Third Edition
Pathology (June 2006) 38(3), pp. 280–281
BOOK REVIEWS
Thurlbeck’s Pathology of the Lung: Third Edition ANDREW M. CHURG, JEFFREY L. MYERS, HENRY D. TAZELAAR, JOANNE L. WRIGHT. Thieme, New York, 2005. ISBN 3-13-665403-X, Hardcover, pp x+1157, US$249.95 It is 10 years since the previous edition of this multi-authored text on lung pathology was published, and in that time there have been major advances in understanding and in classification of both neoplastic and nonneoplastic diseases of the lung. The authors have included contributions made recently in the field of molecular biology and areas of evolving experience including lung transplant pathology. The result is a large and scholarly volume of 1157 pages which covers normal structure, development and specimen handling techniques as well as the full gamut of benign and malignant disease of the lungs and pleura. This tome has several recently published competitors in the pulmonary pathology textbook marketplace, including the Atlas of Non-neoplastic Disorders of the Lower Respiratory Tract by Travis et al., published in 2002 by the Armed Forces Institute of Pathology, the more recent Practical Pulmonary Pathology edited by Leslie and Wick (Churchill Livingstone, 2005), and in the field of lung tumours, Pathology and Genetics of Tumours of the Lung, Thymus and Heart, the WHO publication of 2004 edited by Travis et al. Each of these volumes has one big advantage over the book being reviewed, and that is the use of colour rather than black and white illustrations. It is disappointing that the publishers of this new edition of Thurlbeck could not see their way clear to include more than a handful of colour plates in a book containing hundreds of photographs. The black and white illustrations themselves vary considerably in quality, a few being unfocussed or uninterpretable and many not contributing as much as they could have had they been in colour. A particular strength of this book, more relevant perhaps to pathologists interested in research rather than routine histopathological reporting, are the sections on special techniques and morphometry, particularly in relation to assessment of emphysema and other diseases associated with chronic air flow obstruction. Diagnostic histopathologists should not allow this to deter them from reading the remainder of these chapters which provide detailed discussion of the associated pathogenesis and microscopic pathology. The sections on interstitial (diffuse parenchymal or ‘medical’) lung disease are comprehensive, but it is disappointing to see that cryptogenic organising pneumonia (COP) continues to be referred to as idiopathic bronchiolitis obliterans organising pneumonia (BOOP) in this edition. BOOP is a term that continues to cause confusion for pathologists and clinicians alike, and was therefore discarded by the American Thoracic Society/European Respiratory Society (ATS/ERS) International Consensus Panel in 2002. A few mini gripes about this book include some rather obvious typos (e.g., italicised in the Preface the words ‘apulmonary fibrosis’, and the listing of one of the contributing authors as a ‘Cosultant Histopathologist’). There are also a couple of rather strange organisational quirks (such as discussion of pulmonary PNETs under the heading of minute meningothelioid nodules). These are minor, however, and overall the layout and readability is commendable. If you are looking for a text on lung pathology to be used beside the microscope as an aid to diagnosis, you would probably prefer either the excellent AFIP fascicle backed up by the WHO ‘blue book’ for tumours, or the book edited by Leslie and Wick. If you have a particular interest in pulmonary pathology, you would do well to consider adding this up-todate volume to your library for reference. Lyndal Anderson Department of Anatomical Pathology, Institute of Clinical Pathology and Medical Research, Wesmead Hospital, New South Wales Forensic Neuropathology and Associated Neurology MANFRED OEHMICHEN, ROLAND N. AUER, HANS GU¨NTER KO¨NIG. Springer, Berlin, 2005. ISBN 3540-23500-0, Hardcover, pp xxvi+660, 299J The publication of a new text that attempts to cover the forensic aspects of neuropathology will be welcomed by all who practise in this specialised field. Few subjects produce more discussion or heated debate among forensic pathologists than the pathogenesis of closed head injury in children or the early diagnosis of diffuse cerebral injury, so there will be keen
interest in this German book which is the work of experienced neuropathologists and neuroscientists. No book can be expected to be all things to all people so there will inevitably be some who are disappointed with various aspects of this new publication. However, in general, it fulfils most of the aims set out in the preface, particularly with reference to its attempt to ‘bridge the gap between the...neuroscientist, researcher, medicolegal neuropathologist and clinical physician…’. It is divided into six sections, namely principles of forensic neuropathology, physical trauma, ischaemia and asphyxia, intoxication, paediatric neuropathology and clinical neuropathology. Each section is subdivided into chapters covering the main topics. Therefore the section on physical trauma has chapters on basic principles of mechanical trauma, injuries of the brain’s coverings, open brain injuries, closed brain injuries, injuries of spine and spinal cord, injuries of peripheral nerves and special physical trauma. In this way the subjects are comprehensively covered. Allocating a separate section to paediatric neuropathology recognises the unique and sometimes controversial nature of this subject but it also means that there is an occasional duplication of topic, not necessarily a disadvantage. Despite a publication date of 2006, references are timely and several references dated 2005 are included. Therefore, it is disappointing that in the discussion of the neuropathology of SIDS the recent definitional paper of Krous et al.1 is not cited. Additionally, the sweeping statement that ‘roughly 50% of lesions will be missed if the brain is examined fresh’ is not surprising given the authorship but it would have been useful to back this claim with some scientific evidence. These are fairly minor criticisms. However of greater concern is the rather poor design of the contents list at the beginning of the book. Given that this is the entry to the publication, it needs to be clear and easily used and it needs to facilitate location of any desired topic by the reader. The curious formatting in which there is no indenting of sub-topics and in which there is a confusing numbering system which results in complex outline numbering leads to great difficulty in finding a particular topic. Additionally there is the strange phenomenon where a topic may appear multiple times in one section. For example in the chapter listing for Special Physical Trauma, the sub-topic ‘Clinical Features’ appears eight times! This contents listing should be amended in any future edition as it detracts from an otherwise fine production. Worthy of particular mention is the excellent quality of the illustrations, most of which are in colour, are very sharp, clearly labelled and relevant. Both macro and microphotographs are plentiful and there are clear diagrams when such are necessary to illustrate the narrative. In summary, while not perfect, this is an excellent book. It is not a book to cover all of neuropathology, nor does it pretend to be. It should be a very useful addition to the library of every department that is required to examine forensic cases, as neuropathology is one of the most important subdisciplines that pathologists in this field have to master. Peter Ellis Forensic Medicine, Institute of Clinical Pathology and Medical Research, Westmead Hospital, New South Wales
1. Krous HF, Beckwith JB, Byard RW, et al. Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 2004; 114: 234–8. District Laboratory Practice in Tropical Countries: Second Edition. Part 1 MONICA CHEESBROUGH. Cambridge University Press, Cambridge, 2005. ISBN 0-521-67630-4, Softcover, pp vi+454, £50 This book is in its second edition and has had four previous reprints, indicating its popularity. The book has a number of strengths, particularly its format and the style of writing. It is a light paperback, which is practical for quick reference by practising laboratory personnel. The text is presented in two columns, and many subheadings and bullet points make it easy to read. In many areas of the book there are summarised sections, with the main summary in highlighted boxes. Such formats of presentation are appealing for busy laboratory staff. Further information on certain
ISSN 0031-3025 printed/ISSN 1465-3931 # 2006 Royal College of Pathologists of Australasia DOI: 10.1080/00313020600701122
BOOK REVIEWS
subjects is included in small print for those who are interested in pursuing a topic further. There are adequate illustrations in the form of charts, tables, line diagrams and microscopic pictures. The colour illustrations are located under appropriate sections of the book rather than grouped together. This means that they are not printed on glossy photograph paper; however, they serve their purpose, enabling quick reference. When I started reading this book, I was a little disappointed when I examined the contents page, as the contents of the subsequent parts are not presented. The title of the book is District Laboratory Practice in Tropical Countries: Second Edition. Part 1 and I believe first time readers like me would like to know what goes in the second part or more. The title of the book is appropriate up to the first part of Chapter 6. The rest of Chapter 6 could be applicable to any laboratory, not necessarily a district laboratory, based on the author’s definition of ‘district’. Chapter 5 is on tests on common parasites in the tropics and the list is fairly comprehensive. However, I feel that this chapter should be followed by chapters on other microorganisms common in the tropics: viruses, fungi and bacteria. Instead, it is abruptly followed by a chapter on clinical chemistry tests and I feel the discussion on microorganisms is not complete. If these microorganisms are included in the second part of the book I think they would be more appropriately placed after Chapter 5. Each page carries a page number on the right upper corner and chapter section number on the bottom middle page. I am not sure of the purpose of the latter as it confuses first time readers. I am not familiar with the author’s name. Her qualifications and clinical/ laboratory experience is not stated. Giving such information would add credibility to the book especially for those who are browsing and are not quite familiar with the subjects. I admit this statement is made in the light of my own ignorance, as I have been a practising anatomical pathologist for the last 21 years. I am assuming that the ‘backdrop’ of this book is the tropical African countries rather than tropical countries in Asia, based on the pictures and the acknowledgements. In general, despite the comments made above, the strength of the book is in the facts presented. This is a good ‘guide book’ for people working in laboratories, not necessarily only those in tropical countries. If addressed in future issues, the comments above will make this book better! Nor Hayati Othman Universiti Sains Malaysia, Kelantan, Malaysia Platelet Function: Assessment, Diagnosis, and Treatment MARTIN QUINN, DESMOND FITZGERALD (eds). The Humana Press, Totowa, NJ, 2005. ISBN 1-58829 224-4, Hardcover, pp xi+397, US$125 This book is divided into three sections: seven chapters on platelet physiology; seven chapters on assessing platelet function; and two chapters on clinical applications of anti-platelet agents. The editors have succeeded in bringing together a large number of contributing authors who bring the reader up to date with current understanding of platelet biology and its relevance to laboratory testing and therapeutic approaches. Each chapter is concisely written and extensively referenced. The first chapter overviews platelet physiology, including the actions of platelet agonists such as collagen and ADP in activating platelets. The signalling pathways, adhesion and inflammatory functions of platelets are described. Chapter 2 focuses on platelet integrins and signaling pathways, with detailed descriptions and illustrations of general integrin structure and nomenclature. The structure and functions of specific platelet integrins such as GpIIb/IIIa, outside-in and inside-out signalling pathways associated with them, and how this knowledge is important to the development of antiplatelet agents is described. Chapter 3 details the adhesive and signal transduction functions of platelet receptors such as GpIb-IX-V and the collagen and ADP receptors. Also discussed is the role of protease-activated receptors (PARS) in platelet activation. Chapter 4 describes the structure–function relationships of the actin cytoskeleton in both resting and activated platelets, and the background to the discovery of the protein complex that mediates actin polymerisation, Arp2/3. This chapter includes some excellent photomicrographs of actin filaments and whole platelets undergoing activation, shape change and spreading. The final three chapters on platelet physiology cover platelets and inflammation, signal-dependent protein synthesis and the phosphoproteomics of human platelets. The chapter on platelet function studies describes approaches to evaluating patients with bleeding disorders, including the platelet count, platelet antibodies, platelet aggregation, PFA100 and
281
point-of-care devices. Included is the rationale for the use of specific agonists in relation to receptors and the activation process in platelet aggregometry. Also discussed is the role of flow cytometry in detecting markers of platelet activation such as P selectin following exposure to agonists. Various authors among the remaining chapters also make comment on the usefulness of laboratory methods of assessing platelet function. What the book is not, however, is a detailed handbook of laboratory methods. Chapter 9 has an excellent review on the hydrodynamics of blood flow within vessels, shear stress, and the platelet-VWF interaction and subsequent activation signals that lead to thrombus growth. Another chapter in this section discusses the pharmacodynamics of GpIIb-IIIa receptor blockade and usefulness in preventing thrombus growth in the acute setting. The authors emphasise the importance of standardisation of ex vivo platelet aggregometry to best understand which test may be the most useful in predicting desired therapeutic outcome. The assessment of prostanoid generation by platelet function studies is addressed, with discussion of the action of aspirin and non-steroidal anti-inflammatory drugs on inhibiting the COX enzymes, and potential mechanisms of aspirin resistance. The final two chapters on clinical applications review the literature of clinical trials using various anti-platelet therapies in over 200 000 patients, as well as discussing the usefulness and pitfalls of platelet function testing in trials using GpIIb-IIIa antagonists. In summary, this book brings together a wealth of information from current areas of platelet research and clinical applications of antiplatelet therapy. The book is a very useful reference tool for laboratory workers and clinicians with an interest in platelets. Geoff Kershaw Royal Prince Alfred Hospital, Camperdown, New South Wales Colorectal Tumors: Atlas of Large Section Histopathology TIBOR TOT. Thieme, Stuttgart, 2005. ISBN 1-58890-384-2, Hardcover, pp vi+146, $281.69 Colorectal cancer remains one of the most common malignancies in the Western world and colorectal resection specimens are part of the workload of almost every pathology department. Careful histological evaluation of colorectal resection specimens is critical for accurate staging, which dictates patient management and is essential for meaningful research. This atlas will help readers to understand and correctly interpret observed microscopic features and will be instrumental in realising the importance of adequate sampling of resection specimens. This book has been divided into chapters that describe benign conditions, precursors of colorectal cancer, early and advanced colorectal adenocarcinoma and non-epithelial malignancies, with the final chapter devoted to technical considerations. Each case includes brief but essential clinical data and follow-up information. The book is illustrated with large, high quality images of H&E stained sections with a supporting schematic guide to the discussed morphological details. Large histology sections are particularly useful in correlating pathology findings such as radial resection margin status and distribution of cancer with pre-operative imaging, including CT and MRI, which are now increasingly used in specialised colorectal surgery units. This atlas should be viewed not only as a source of detailed images of large histological sections, which display the pathology of both neoplastic and nonneoplastic colorectal lesions, but also as a useful guide in helping to solve problems that may be encountered during the reporting of colorectal cancers. The author and his laboratory team should be congratulated on the outstanding quality of the presented material, selection of problem cases and the included comments and practical points. This book is a valuable tool, not only for clinicians involved in the treatment of patients with intestinal tumours, but also for pathology trainees and those of us who routinely report on colorectal cancer resections. With sampling practices being increasingly impacted on by costcontainment issues, labour-intense and time consuming techniques such as large section histopathology are unlikely to become widely used methods for the evaluation of intestinal specimens from radical surgery outside of specialised pathology laboratories. These minor comments should not diminish the value of this atlas which should find its place on shelves of not only those who want to better understand the pathology of colorectal tumours, but also of those who routinely report on intestinal resections specimens. Andrew Ruszkiewicz Division of Tissue Pathology, Gastroenterology Research Laboratory, Institute of Medical and Veterinary Science, Adelaide, South Australia
BOOK REVIEWS
Thurlbeck’s Pathology of the Lung: Third Edition ANDREW M. CHURG, JEFFREY L. MYERS, HENRY D. TAZELAAR, JOANNE L. WRIGHT. Thieme, New York, 2005. ISBN 3-13-665403-X, Hardcover, pp x+1157, US$249.95 It is 10 years since the previous edition of this multi-authored text on lung pathology was published, and in that time there have been major advances in understanding and in classification of both neoplastic and nonneoplastic diseases of the lung. The authors have included contributions made recently in the field of molecular biology and areas of evolving experience including lung transplant pathology. The result is a large and scholarly volume of 1157 pages which covers normal structure, development and specimen handling techniques as well as the full gamut of benign and malignant disease of the lungs and pleura. This tome has several recently published competitors in the pulmonary pathology textbook marketplace, including the Atlas of Non-neoplastic Disorders of the Lower Respiratory Tract by Travis et al., published in 2002 by the Armed Forces Institute of Pathology, the more recent Practical Pulmonary Pathology edited by Leslie and Wick (Churchill Livingstone, 2005), and in the field of lung tumours, Pathology and Genetics of Tumours of the Lung, Thymus and Heart, the WHO publication of 2004 edited by Travis et al. Each of these volumes has one big advantage over the book being reviewed, and that is the use of colour rather than black and white illustrations. It is disappointing that the publishers of this new edition of Thurlbeck could not see their way clear to include more than a handful of colour plates in a book containing hundreds of photographs. The black and white illustrations themselves vary considerably in quality, a few being unfocussed or uninterpretable and many not contributing as much as they could have had they been in colour. A particular strength of this book, more relevant perhaps to pathologists interested in research rather than routine histopathological reporting, are the sections on special techniques and morphometry, particularly in relation to assessment of emphysema and other diseases associated with chronic air flow obstruction. Diagnostic histopathologists should not allow this to deter them from reading the remainder of these chapters which provide detailed discussion of the associated pathogenesis and microscopic pathology. The sections on interstitial (diffuse parenchymal or ‘medical’) lung disease are comprehensive, but it is disappointing to see that cryptogenic organising pneumonia (COP) continues to be referred to as idiopathic bronchiolitis obliterans organising pneumonia (BOOP) in this edition. BOOP is a term that continues to cause confusion for pathologists and clinicians alike, and was therefore discarded by the American Thoracic Society/European Respiratory Society (ATS/ERS) International Consensus Panel in 2002. A few mini gripes about this book include some rather obvious typos (e.g., italicised in the Preface the words ‘apulmonary fibrosis’, and the listing of one of the contributing authors as a ‘Cosultant Histopathologist’). There are also a couple of rather strange organisational quirks (such as discussion of pulmonary PNETs under the heading of minute meningothelioid nodules). These are minor, however, and overall the layout and readability is commendable. If you are looking for a text on lung pathology to be used beside the microscope as an aid to diagnosis, you would probably prefer either the excellent AFIP fascicle backed up by the WHO ‘blue book’ for tumours, or the book edited by Leslie and Wick. If you have a particular interest in pulmonary pathology, you would do well to consider adding this up-todate volume to your library for reference. Lyndal Anderson Department of Anatomical Pathology, Institute of Clinical Pathology and Medical Research, Wesmead Hospital, New South Wales Forensic Neuropathology and Associated Neurology MANFRED OEHMICHEN, ROLAND N. AUER, HANS GU¨NTER KO¨NIG. Springer, Berlin, 2005. ISBN 3540-23500-0, Hardcover, pp xxvi+660, 299J The publication of a new text that attempts to cover the forensic aspects of neuropathology will be welcomed by all who practise in this specialised field. Few subjects produce more discussion or heated debate among forensic pathologists than the pathogenesis of closed head injury in children or the early diagnosis of diffuse cerebral injury, so there will be keen
interest in this German book which is the work of experienced neuropathologists and neuroscientists. No book can be expected to be all things to all people so there will inevitably be some who are disappointed with various aspects of this new publication. However, in general, it fulfils most of the aims set out in the preface, particularly with reference to its attempt to ‘bridge the gap between the...neuroscientist, researcher, medicolegal neuropathologist and clinical physician…’. It is divided into six sections, namely principles of forensic neuropathology, physical trauma, ischaemia and asphyxia, intoxication, paediatric neuropathology and clinical neuropathology. Each section is subdivided into chapters covering the main topics. Therefore the section on physical trauma has chapters on basic principles of mechanical trauma, injuries of the brain’s coverings, open brain injuries, closed brain injuries, injuries of spine and spinal cord, injuries of peripheral nerves and special physical trauma. In this way the subjects are comprehensively covered. Allocating a separate section to paediatric neuropathology recognises the unique and sometimes controversial nature of this subject but it also means that there is an occasional duplication of topic, not necessarily a disadvantage. Despite a publication date of 2006, references are timely and several references dated 2005 are included. Therefore, it is disappointing that in the discussion of the neuropathology of SIDS the recent definitional paper of Krous et al.1 is not cited. Additionally, the sweeping statement that ‘roughly 50% of lesions will be missed if the brain is examined fresh’ is not surprising given the authorship but it would have been useful to back this claim with some scientific evidence. These are fairly minor criticisms. However of greater concern is the rather poor design of the contents list at the beginning of the book. Given that this is the entry to the publication, it needs to be clear and easily used and it needs to facilitate location of any desired topic by the reader. The curious formatting in which there is no indenting of sub-topics and in which there is a confusing numbering system which results in complex outline numbering leads to great difficulty in finding a particular topic. Additionally there is the strange phenomenon where a topic may appear multiple times in one section. For example in the chapter listing for Special Physical Trauma, the sub-topic ‘Clinical Features’ appears eight times! This contents listing should be amended in any future edition as it detracts from an otherwise fine production. Worthy of particular mention is the excellent quality of the illustrations, most of which are in colour, are very sharp, clearly labelled and relevant. Both macro and microphotographs are plentiful and there are clear diagrams when such are necessary to illustrate the narrative. In summary, while not perfect, this is an excellent book. It is not a book to cover all of neuropathology, nor does it pretend to be. It should be a very useful addition to the library of every department that is required to examine forensic cases, as neuropathology is one of the most important subdisciplines that pathologists in this field have to master. Peter Ellis Forensic Medicine, Institute of Clinical Pathology and Medical Research, Westmead Hospital, New South Wales
1. Krous HF, Beckwith JB, Byard RW, et al. Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 2004; 114: 234–8. District Laboratory Practice in Tropical Countries: Second Edition. Part 1 MONICA CHEESBROUGH. Cambridge University Press, Cambridge, 2005. ISBN 0-521-67630-4, Softcover, pp vi+454, £50 This book is in its second edition and has had four previous reprints, indicating its popularity. The book has a number of strengths, particularly its format and the style of writing. It is a light paperback, which is practical for quick reference by practising laboratory personnel. The text is presented in two columns, and many subheadings and bullet points make it easy to read. In many areas of the book there are summarised sections, with the main summary in highlighted boxes. Such formats of presentation are appealing for busy laboratory staff. Further information on certain
ISSN 0031-3025 printed/ISSN 1465-3931 # 2006 Royal College of Pathologists of Australasia DOI: 10.1080/00313020600701122
BOOK REVIEWS
subjects is included in small print for those who are interested in pursuing a topic further. There are adequate illustrations in the form of charts, tables, line diagrams and microscopic pictures. The colour illustrations are located under appropriate sections of the book rather than grouped together. This means that they are not printed on glossy photograph paper; however, they serve their purpose, enabling quick reference. When I started reading this book, I was a little disappointed when I examined the contents page, as the contents of the subsequent parts are not presented. The title of the book is District Laboratory Practice in Tropical Countries: Second Edition. Part 1 and I believe first time readers like me would like to know what goes in the second part or more. The title of the book is appropriate up to the first part of Chapter 6. The rest of Chapter 6 could be applicable to any laboratory, not necessarily a district laboratory, based on the author’s definition of ‘district’. Chapter 5 is on tests on common parasites in the tropics and the list is fairly comprehensive. However, I feel that this chapter should be followed by chapters on other microorganisms common in the tropics: viruses, fungi and bacteria. Instead, it is abruptly followed by a chapter on clinical chemistry tests and I feel the discussion on microorganisms is not complete. If these microorganisms are included in the second part of the book I think they would be more appropriately placed after Chapter 5. Each page carries a page number on the right upper corner and chapter section number on the bottom middle page. I am not sure of the purpose of the latter as it confuses first time readers. I am not familiar with the author’s name. Her qualifications and clinical/ laboratory experience is not stated. Giving such information would add credibility to the book especially for those who are browsing and are not quite familiar with the subjects. I admit this statement is made in the light of my own ignorance, as I have been a practising anatomical pathologist for the last 21 years. I am assuming that the ‘backdrop’ of this book is the tropical African countries rather than tropical countries in Asia, based on the pictures and the acknowledgements. In general, despite the comments made above, the strength of the book is in the facts presented. This is a good ‘guide book’ for people working in laboratories, not necessarily only those in tropical countries. If addressed in future issues, the comments above will make this book better! Nor Hayati Othman Universiti Sains Malaysia, Kelantan, Malaysia Platelet Function: Assessment, Diagnosis, and Treatment MARTIN QUINN, DESMOND FITZGERALD (eds). The Humana Press, Totowa, NJ, 2005. ISBN 1-58829 224-4, Hardcover, pp xi+397, US$125 This book is divided into three sections: seven chapters on platelet physiology; seven chapters on assessing platelet function; and two chapters on clinical applications of anti-platelet agents. The editors have succeeded in bringing together a large number of contributing authors who bring the reader up to date with current understanding of platelet biology and its relevance to laboratory testing and therapeutic approaches. Each chapter is concisely written and extensively referenced. The first chapter overviews platelet physiology, including the actions of platelet agonists such as collagen and ADP in activating platelets. The signalling pathways, adhesion and inflammatory functions of platelets are described. Chapter 2 focuses on platelet integrins and signaling pathways, with detailed descriptions and illustrations of general integrin structure and nomenclature. The structure and functions of specific platelet integrins such as GpIIb/IIIa, outside-in and inside-out signalling pathways associated with them, and how this knowledge is important to the development of antiplatelet agents is described. Chapter 3 details the adhesive and signal transduction functions of platelet receptors such as GpIb-IX-V and the collagen and ADP receptors. Also discussed is the role of protease-activated receptors (PARS) in platelet activation. Chapter 4 describes the structure–function relationships of the actin cytoskeleton in both resting and activated platelets, and the background to the discovery of the protein complex that mediates actin polymerisation, Arp2/3. This chapter includes some excellent photomicrographs of actin filaments and whole platelets undergoing activation, shape change and spreading. The final three chapters on platelet physiology cover platelets and inflammation, signal-dependent protein synthesis and the phosphoproteomics of human platelets. The chapter on platelet function studies describes approaches to evaluating patients with bleeding disorders, including the platelet count, platelet antibodies, platelet aggregation, PFA100 and
281
point-of-care devices. Included is the rationale for the use of specific agonists in relation to receptors and the activation process in platelet aggregometry. Also discussed is the role of flow cytometry in detecting markers of platelet activation such as P selectin following exposure to agonists. Various authors among the remaining chapters also make comment on the usefulness of laboratory methods of assessing platelet function. What the book is not, however, is a detailed handbook of laboratory methods. Chapter 9 has an excellent review on the hydrodynamics of blood flow within vessels, shear stress, and the platelet-VWF interaction and subsequent activation signals that lead to thrombus growth. Another chapter in this section discusses the pharmacodynamics of GpIIb-IIIa receptor blockade and usefulness in preventing thrombus growth in the acute setting. The authors emphasise the importance of standardisation of ex vivo platelet aggregometry to best understand which test may be the most useful in predicting desired therapeutic outcome. The assessment of prostanoid generation by platelet function studies is addressed, with discussion of the action of aspirin and non-steroidal anti-inflammatory drugs on inhibiting the COX enzymes, and potential mechanisms of aspirin resistance. The final two chapters on clinical applications review the literature of clinical trials using various anti-platelet therapies in over 200 000 patients, as well as discussing the usefulness and pitfalls of platelet function testing in trials using GpIIb-IIIa antagonists. In summary, this book brings together a wealth of information from current areas of platelet research and clinical applications of antiplatelet therapy. The book is a very useful reference tool for laboratory workers and clinicians with an interest in platelets. Geoff Kershaw Royal Prince Alfred Hospital, Camperdown, New South Wales Colorectal Tumors: Atlas of Large Section Histopathology TIBOR TOT. Thieme, Stuttgart, 2005. ISBN 1-58890-384-2, Hardcover, pp vi+146, $281.69 Colorectal cancer remains one of the most common malignancies in the Western world and colorectal resection specimens are part of the workload of almost every pathology department. Careful histological evaluation of colorectal resection specimens is critical for accurate staging, which dictates patient management and is essential for meaningful research. This atlas will help readers to understand and correctly interpret observed microscopic features and will be instrumental in realising the importance of adequate sampling of resection specimens. This book has been divided into chapters that describe benign conditions, precursors of colorectal cancer, early and advanced colorectal adenocarcinoma and non-epithelial malignancies, with the final chapter devoted to technical considerations. Each case includes brief but essential clinical data and follow-up information. The book is illustrated with large, high quality images of H&E stained sections with a supporting schematic guide to the discussed morphological details. Large histology sections are particularly useful in correlating pathology findings such as radial resection margin status and distribution of cancer with pre-operative imaging, including CT and MRI, which are now increasingly used in specialised colorectal surgery units. This atlas should be viewed not only as a source of detailed images of large histological sections, which display the pathology of both neoplastic and nonneoplastic colorectal lesions, but also as a useful guide in helping to solve problems that may be encountered during the reporting of colorectal cancers. The author and his laboratory team should be congratulated on the outstanding quality of the presented material, selection of problem cases and the included comments and practical points. This book is a valuable tool, not only for clinicians involved in the treatment of patients with intestinal tumours, but also for pathology trainees and those of us who routinely report on colorectal cancer resections. With sampling practices being increasingly impacted on by costcontainment issues, labour-intense and time consuming techniques such as large section histopathology are unlikely to become widely used methods for the evaluation of intestinal specimens from radical surgery outside of specialised pathology laboratories. These minor comments should not diminish the value of this atlas which should find its place on shelves of not only those who want to better understand the pathology of colorectal tumours, but also of those who routinely report on intestinal resections specimens. Andrew Ruszkiewicz Division of Tissue Pathology, Gastroenterology Research Laboratory, Institute of Medical and Veterinary Science, Adelaide, South Australia