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Diagnostic Surgical Pathology. Volumes 1 and 2, 3rd ed.
  1. T J Stephenson

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    Sternberg SS, ed. ($325.) Lippincott, 1999. ISBN 0 3975 8792 9.

    At 56 chapters written by 93 authors and extending to 2445 pages, this is the third edition of Sternberg's Diagnostic Surgical Pathology and a heavy weight re-entry into the mighty two and three volume all embracing histopathology tome market. The preface by the editor and his four associates promises us “the latest on PMETs”. I am not quite sure what PMETs are. Perhaps they are secondary deposits from PNETs! Typographical errors aside, on a more positive note, the promise of a revised lymphoma classification, an update on gut lymphomas and those of the skin, a reclassification of papillary urothelial neoplasms, the introduction of new aspects of kidney tumours, modernisation of the approach to gastrointestinal stromal tumours, new concepts in ductal carcinoma in situ of the breast and handling of breast specimens, and an update of chapters on urothelial and paediatric neoplasms is well met. There is substantial new information in this edition. The references appear to cut out in late 1998 which, given the complexity of editing a work of this magnitude, probably represents the most up to date information that can be expected. Although the sections on new diagnostic techniques such as molecular biology have been expanded, the work remains grounded in diagnostic histopathology. The general background to each disease process is well described and the clinicopathological correlations are dealt with well; this book is well placed to inform multidisciplinary care.

    The transition to almost all full colour illustrations is heralded as a major advance to this edition. Although many of the pictures are of good quality and many do add information that could not be obtained from a monochrome image, the quality of the colour reproduction does vary enormously between the chapters. For example, that by R R Heffner on muscle biopsy in neuromuscular disease has excellent illustrations, whereas that by A M Hanby and two other authors on the breast has particularly poor ones, with some of the worst examples of colour casts and low contrast in any current professional textbook. I do not think that the editors should have let this through. The scope of the textbook is very wide and the depth of knowledge and discussion achieved is commendable, but again this is a point that varies from chapter to chapter, suggesting some editorial inconsistency.

    More fundamental questions are: What is the purpose of giant multiauthor texts like this, who needs them, when will they be used and how, and if they are required, what is the “pecking order” for choice of these? Very often better written, more detailed, and more up to date descriptions exist in system specific texts. The constraints of producing a multi author work like this mean that the individual chapters are unlikely to rival the detail of the specialised book. However, I suspect most of us consult books like this on the areas in which we do not have specialised texts. Apart from this text, this market segment appears to include Ackerman's Surgical Pathology edited by Rosai, Anderson's Pathology edited by Damjanov and Linder, and Silverberg's Principles and Practice of Surgical Pathology. Perhaps the Oxford Textbook of Pathology is not a direct competitor because its remit is so different. The choice of which of these books to consult is a personal matter, depending on preferred style and balance of writing. In my view, Ackerman is particularly commendable for Rosai's masterful treatment of differential diagnosis in surgical pathology, Silverberg is brief and to the point, yet quite detailed, and Anderson's Pathology is good for clinicopathological correlations and the general context of disease. This text lies somewhere in the middle, meeting several of the purposes, but to my mind it is beaten for quality of histological description by the first two works, although still very worthwhile if funds allow its purchase.

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