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Biopsy Interpretation of Bone and Bone Marrow: Histology and Immunohistology in Paraffin and Plastic, 2nd ed.
  1. P Kluin

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    B Frisch, R Bartl. (£98.50.) Arnold (co-published with Oxford University Press in USA), 1999. ISBN 0 340 74089 2.

    Biopsy Interpretation of Bone and Bone Marrow is a second, completely revised edition of a similar book published in 1985 by the same authors, but the book also resembles the Atlas of Bone Marrow Pathology published in 1990 by these authors.

    In 31 chapters, the authors give a comprehensive overview of the diagnostic features of most disorders of the bone and bone marrow. After four introductory chapters, nine chapters are entirely dedicated to bone diseases. In chapter 14, metastic bone disease is described, and in the following chapters most bone marrow disorders including the lymphoproliferative disorders are described. Sometimes, an introductory chapter precedes more specific chapters.

    The book contains highly valuable information on issues that are not easily found in other text books, especially on bone diseases. It reflects the enormous experience of both authors in this field of diagnostic pathology.

    In general, each chapter is clearly written and contains comprehensive tables either listing general features of a specific disorder, clinical characteristics, histological characteristics, or checklists.

    The layout is excellent and the illustrations (most representing Giemsa stained slides of plastic embedded biopsies) with the schematic drawings are really superb.

    However, there is also some criticism possible: in general, the background information (especially on pathophysiology) for each disorder is limited and the text is often relatively superficial. Just to give one example, in chapter 18, brief information on the different types of haemolytic disorders should be given, at least to alert the pathologist to the possibility of detecting a non-Hodgkin's lymphoma in the biopsy in association with cold agglutinin disease.

    In some chapters, the data are incorrect. For instance, in the lymphoma chapters 25 and 27, data on the localisation of specific subtypes of non-Hodgkin's lymphomas are given. According to these data mantle cell lymphoma has a preferential paratrabecular localisation. This is incorrect, the infiltrates in mantle cell lymphoma being patchy and entirely random. It is likely that the described paratrabecular infiltrates represent localisation of follicle centre cell lymphomas with very few centroblasts often mixed up with centrocytic lymphoma in the past, but now very easy to distinguish with immunohistochemistry. An amusing error is shown in tables 25.6 and 25.7 because the REAL and ILSG classifications are essentially the same, the author probably referring to the novel WHO classification in table 25.7. An insufficient updating in this area is also illustrated by the absence of more recently described entities such as hepatosplenic γδ T cell lymphoma with a diagnostic intrasinusoidal pattern of neoplastic T cells, best visible in bone marrow biopsies. In these chapters on lymphomas many other (small) errors, also concerning the cytogenetic data, can be found.

    One disturbing general feature of the book is the lack of specific references in the text, whereas the references are listed alphabetically after each chapter. This makes it almost impossible to go back to the original literature data. A related weakness is the lack of quotation of sources in cases where detailed numerical data are given. For instance, in chapter 14 metastatic bone disease is described and data on the incidence of metastasis in breast cancer, prostate cancer, etc, are given. These data seem to be derived from the authors' large collections, but it is unclear how these series were selected (for instance, an incidence of 42% positive bone marrow biopsies in a random series of patients with breast cancer is very high and suggests that this represented a selected series of patients with advanced disease).

    In summary, this book is an excellent atlas of bone and bone marrow pathology and as such it is an important adjunct for each (haemato)pathologist. However, it is of limited value to obtain adequate (background) information.

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