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Biopsy Interpretation of Bone and Bone Marrow; Histology and Immunohistology in Paraffin and Plastic.
  1. B J Bain

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    Cytogenetics in collaboration with Rothman, R. 2nd ed. Frisch B, Bartl R. (£95.00.) Arnold, 1999. ISBN 0 340 74089 2.J Clin Pathol 2001;54:575–576

    This book is beautifully produced and, as one would expect from these two authors, is generally very well illustrated. It is based largely on the authors' very extensive experience of trephine biopsy histology and is therefore not extensively referenced. In contrast to the previous edition, illustrations are now derived from sections of paraffin wax embedded as well as plastic embedded biopsy specimens; pathologists from countries where plastic embedding is little used will appreciate this feature. Illustrative diagrams are clear and helpful and the literary style is clear.

    Despite the title, this book deals only with the interpretation of histological features of core biopsies (or open biopsies). Aspiration biopsy of the bone marrow is largely ignored and I succeeded in finding only a single photograph of an aspirate—a Perls's stain of ring sideroblasts. This will be a definite disadvantage for many haematologists and may encourage histopathologists to undervalue the role of aspiration cytology.

    A third of the book deals with bone histology. This section is particularly comprehensive and useful. It also serves to remind the reader of the close relation between bone and bone marrow, and of the influence of bone disease on bone marrow histology. Perhaps this section of the book will encourage both histopathologists and haematologists to make a careful assessment of the bone before turning their attention to the haemopoietic tissue.

    The two thirds of the book that deals with the bone marrow gives a detailed account of bone marrow histology. Although bone marrow aspirates are not discussed some consideration is given to immunophenotyping and cytogenetic analysis. There are no serious omissions.

    Are there any problems with this book? I found some of the illustrations to be at too low a power to be really informative. I also regretted the lack of information on magnification; there is not always a ready point of reference so that the reader may be able to get an impression of the size of any abnormal cells. In the latter fault this book is not unique; it is one of many contemporary histopathology textbooks that do not feel the need to inform the reader of the magnification of the photomicrographs.

    If one wished to find individual errors a careful reading will unearth several. The authors carry over from the previous edition the concept that paratrabecular infiltration is not seen in centroblastic/centrocytic lymphoma whereas a nodular pattern of infiltration is common; this puzzling observation is contrary to the findings of most other haematopathologists. The grouping of very diverse inherited and acquired conditions under the heading of “Langerhans cell histiocytosis” is unhelpful, and at least one of the translocations given as characteristic of malignant histiocytosis in this table is much more typical of anaplastic large cell lymphoma, indicating previous diagnostic confusion between these two conditions. The authors' use of the term “granuloma” to describe the focal lesions of systemic mastocytosis is confusing, as is their use of the term “biopsy” to describe tissue obtained after death. Nevertheless, in a book of 367 pages, covering such a large field, mistakes are probably inevitable and one can only sympathise. The authors probably became aware of many of these errors shortly after publication.

    Overall, a well illustrated account of bone marrow histology with bone histology being a particular strength.

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