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Layfield LJ. (£115.00.) Oxford University Press, 2002. ISBN 0 19 513236 X.
“Fine needle aspiration (FNA) is only now gaining acceptance as a primary modality for the study of musculoskeletal lesions.” So opens the preface to this book, and immediately the reader needs to choose how they are going to receive this statement. If you are sceptical then read the rest of the preface for its outline of the justification of FNA in this context, prepared to stay on the ship if persuaded; if you instantly agree then dive straight into the first chapter. It is an introduction, but with more than just technical aspects and analysis of rates of success or failure; the cost aware can read how many dollars are saved by FNA compared with open biopsies. Of more value are the tables and diagrams summarising cellular features in benign and malignant lesions, and algorithms for diagnosis. If you are going to use FNA for this purpose then get a copy of these tables on to the wall in front of you.
Most of the book works systematically through soft tissue and then bone tumours, using a standard pattern giving a description or overview, histological findings, cytological findings, problems in diagnosis, and a summary of key features. The text is clearly written, with good descriptions of the cellular features, and numerous illustrations: bullet points give added clarity where appropriate.
So what are you hoping to achieve by reading this book?
Are you part of a soft tissue/bone MDT actively involved in diagnosis, with appropriate discussion and information? This book will get you started.
Are you active in cytopathology and liable to receive incidental soft tissue pathology? This book should help prevent some errors, and will provoke clinical liaison.
Are you a histopathologist who is an occasional cytopathologist? All the illustrations will look the same, and you should not expect to make a useful comment most of the time.
In summary, this is a well written text on a difficult subject, with clearly presented information. Should you show this book to your clinical colleagues to encourage them to use FNA more often? It depends on whether you are an enthusiast.
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