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Essentials of Anatomic Pathology
  1. S Cross

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    Cheng L, Bostwick DG, eds. ($175.00.) Humana Press, 2002. ISBN 1 58829 118 9.

    What is the best format to store and transmit information? With the development of electronic storage media and the Internet, paper is not always the first choice but even if it is then there are other decisions to be made. Will the book be illustrated? Will it be written in fully expanded grammatical prose or will some information be contained in lists and tables? How will it be indexed? What degree of cross referencing will be included?

    The authors of this textbook have taken the unusual step of producing a large (893 page) multiauthor text on anatomical pathology with no illustrations and all the text presented as succinct bulleted lists. Because I come from the “picture is worth a thousand words” school of information presentation and assimilation, I was initially sceptical of this approach, but I spent some time investigating the usefulness of this format.

    The book is divided into general pathology and organ systems. Each organ chapter is divided into the usual categories of congenital anomalies, inflammatory, and neoplastic conditions. Each condition has its features listed under headings such as clinical, macroscopic, microscopic, immunohistochemistry, electron microscopy, and differential diagnosis. However, these are pure lists with very little explanatory text. Any technical description of a histology appearance—for example, pineocytic rosettes or nuclear pseudoinclusions—will send trainee pathologists scurrying to a book that does contain a picture. Any list of immunohistochemical reactions given as only positive or negative sent me to other sources of information for the pattern of staining and the percentage of specific tumours that did or did not give a positive reaction. I discovered several anomalies in the text that required further explanation. Ductal intraepithelial of the breast is presented as though it is the universally accepted system of classification of epithelial proliferations in the breast. The reporting of oestrogen receptor status in breast cancer is said to be positive if greater than 10% of nuclei are positive, with no reference to the more sophisticated and widely used McCarty H score. There is no mention of Her 2 assessment in breast cancer or c-kit in gastrointestinal stromal tumours of the oesophagus and stomach (it is mentioned as a diagnostic immunohistochemical stain in the intestinal chapter). Somewhat surprisingly, this book does not have an index so that information can only be found through the contents list at the start of each chapter.

    Despite the best intentions of the authors of this book I cannot find any use for it within a diagnostic histopathology laboratory for either consultant or trainee pathologists. The absence of illustrations, the list format of the text, and the absence of an index mean that there are a multitude of more accessible and useful sources of this information.

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