JOURNAL OF PATHOLOGY, VOL. 163: 273-276 (1991)

BOOK REVIEWS

Pathology of the Nucleus (Current Topics in Pathology, Vol. 82) . J. C. E. UNDERWOOD (Ed.). Springer-Verlag, Heidelberg, 1990. No. of pages: 343. Price: DM 264 (approx. f90). ISBN: 3 540 510184.

The title of this volume in the Current Topics in Pathol- ogy series is somewhat misleading as this relatively small volume could never encompass the full range of its title. Rather, it consists of a series of reviews, each based on a particular method of investigation.

The book opens with an introduction by the editor which reviews some of the morphological cornerstones of surgical pathology. This is well written and clearly illus- trated, the style being reminiscent of Underwood’s ‘Intro- duction to Biopsy Interpretation and Surgical Pathology, and as such, might be of interest and use to the readers who are not surgical pathologists. This is followed by a lengthy review of the ultrastructural appearances of the nucleus, which occasionally becomes tedious, particularly as one is necessarily reminded of the non-specific nature of many of the appearances described therein. This tedium is broken by the occasional anachronism such as the use of the term ‘granular cell myoblastoma’ and the use of Sendai virus in hybridoma production. Crocker has written a useful historical review of the inevitable AgNOR in which the paucity of proper prognostic studies is stressed. This chapter includes a cookbook section on the demonstration of nucleolar organizer regions which, while useful in itself, illustrates a lack of editorial uniformity as recipes do not appear in other chapters.

There are two useful chapters covering image analysis and flow cytometry which would provide useful back- ground reading for those applying these methods. How- ever, the chapter on karyotypic analysis of solid tumours is disappointing, as it resembles a catalogue with little consideration of the potential molecular mechanisms whereby karyotypic abnormalities are translated into a malignant phenotype. Potential readers should note that lymphomas are not included among the solid tumours. The chapter on in-situ hybridization is a useful overview, although marred by an excess of typographical errors.

The role of this book is difficult to define. It is not a complete account of the pathology of the nucleus, import- ant areas such as apoptosis, radiation damage, and toxi- cology being neglected. Equally, it is not a bench book for those investigating the molecular mechanisms of malig- nancy. Those about to use some of the methods described in this book may find that it provides some useful back- ground reading, although few may be able to justify the expenditure of in excess of DO. It may find a place in the libraries of institutions where these techniques are being

0 1991 by John Wiley & Sons, Ltd.

applied although, like many volumes in this series, it cannot be regarded as good value for money.

WILLIAM R. ROCHE University of Southampton

Pediatric Hepatology. W. F. BALISTRERI and J. T. STOCKER. Hemisphere, New York, 1990. No. of pages: 498. Price: E100. ISBN: 0 891 16 738 2.

This book is the third of a series of monographs on various aspects of paediatric disease, based on yearly seminars held at Aspen, Colorado, U.S.A. Emphasis is laid on a multidisciplinary approach and the result is a text that should be of interest to pathologists as well as to physicians and surgeons. In fact, the histopathological aspects are described in detail and most of the 200 or so illustrations depict gross morphological and microscopic appearances. References run up to the end of 1988 and the book is up to date.

The first two chapters cover the medical and surgical aspects of ‘infantile cholangiopathy’, i.e., the neonatal hepatitis/biliary atresia spectrum of disorders and their many variants that are now regarded as closely related entities albeit of multiple aetiologies: viral, metabolic, and developmental. An account then follows of total paren- teral nutrition-associated cholestasis, which remains something of a pathogenetic mystery, and of its sequelae, which may be severe.

The fourth chapter on medical management of neo- natal cholestasis emphasizes that many of its causes are treatable and others are a t least manageable. Early sur- gical treatment, i.e., by 8 weeks of age, of extrahepatic biliary obstruction remains as imperative as ever. Sadly, these infants are often clinically well and the operation is delayed until too late. The results of transplantation, however, are improving; major advances have included the introduction of cyclosporine, the advent of the University of Wisconsin solution for organ preservation, and the use of reduced size transplants, i.e., lobes or multiple segments of liver.

The fifth chapter on the pathology of inherited meta- bolic disorders is outstanding and probably of the greatest interest to pathologists. It is fully illustrated with 66 figures and supported by 373 references: if you wish to know about leprechaunism or the syndromes of Aarskog and of Hermansky and Pudlak, you need look no further. The subsequent chapter on alpha-1 -antitrypsin de- ficiency rightly emphasizes the importance of this, the

274 BOOK REVIEWS

commonest, form of inherited metabolic disorder. A use- ful chapter on screening for metabolic liver diseases, both in infants and in young children, then follows. The latter mainly concerns Reye’s syndrome and its differential di- agnosis and this is further elaborated in the following contribution. An account of systemic disorders that may be associated with liver dysfunction includes haemolytic anaemias; cardiac failure; renal, gastrointestinal, and endocrine causes; and, inevitably, AIDS.

Drug-induced liver disease is fully documented in Chapter 10. The next three accounts concern acute and chronic hepatitis and their pathology; all are clearly writ- ten and include reference to recent advances in delineating hepatitis C (post-transfusion non-A, non-B hepatitis) and hepatitis E (the enteric form). There is a particularly vivid account of fulminant hepatitis in Chapter 14, with illustrative examples. Chapters 15 and 16 return to the surgical and pathological aspects of liver transplantation, an ever-growing field: more than 40 liver transplant centres now exist in the United States and a dozen or so in Western Europe. The last chapter on paediatric liver tumours is exhaustive and, again, of particular interest to pathologists. Indeed, it is written by a pathologist but the results of current therapeutic approaches are fully covered.

It is requested of reviewers of this journal that the book under scrutiny is compared for value with others in the field. Monographs or proceedings of symposia do not aim at such comprehensive cover as textbooks and, in this sense, two recent works are more didactic. These are Liver Disorders in Childhood by A. P. Mowat (Butterworths, 1987) and the second edition of Textbook of Pediatric Pathology by A. R. Colon (Year Book Medical Publishers, 1990), the first of which was an instant classic and the second is very good indeed. Pediatric Hepatology com- pares well with these and is best in its class: all important problems are fully dealt with. I t is highly recommended to libraries, paediatricians, and liver pathologists.

PETER ANTHONY Exeter

Histological Typing of Oesophageal and Gastric Tumours. 2nd ed. H. WATANABE, J. R. JASS and L. H. SOBIN, Springer-Verlag, Berlin, 1990. No. of pages 109. Price DM78. ISBN 3 540 51629 8.

Is there anything new or controversial to say about such a standard text? Surely the second edition of the WHO international classification volume on oesophageal and gastric tumours, a relatively uncontroversial area, will provide no major areas of consternation. Oesophagus, no problem. In gastric tumours, as with the first edition, the classification of adenocarcinoma concentrates on tra- ditional, morphological terms such as papillary and tubu- lar (does anyone use these terms in routine reporting?) and steers clear of Lauren-type systems. I then was faced with

lymphoma of the stomach. Concepts of gastrointestinal lymphoma have undergone a major overhaul in recent years and only a little of the current thinking has been introduced into the WHO classification. This is a shame. This is a major reference book, one so often quoted. Is the work of Isaacson and others to come to nought in the eyes of these international pathologists? It is a disappointment that black and white production is predominant with only a few colour photomicrographs at the rear of the book. In general, the text is accurate-I could find just two minor errors-reference is made to ‘familial adenomatosis coli’ and there is a gremlin, possibly a budding yeast, in one lymphoma photomicrograph. In conclusion, this is a book that many will reference and many departments and libraries will buy: how many will actually find it useful is more debatable.

N. A. SHEPHERD Glouces tershire Royal Hospital

Surgical Pathology of the Breast K. ROGERS and A. J. COUP. Butterworth Scientific Ltd., Guildford, 1990. No. of pages: 149. Price: L39.50. ISBN: 0 7236 0965 9.

The preface to this book indicates that it is aimed at undergraduates and postgraduates in the field of surgery, radiotherapy, and oncology, while those involved in breast screening and pathology training may find it of value. This is a broad audience, who are likely to view their needs and how they can be helped in different ways. However, surgeons appear to be the main target.

The first two chapters are devoted to the normal breast and diagnostic methods; the next two to benign lesions and the nipple; then there are four concerned with carci- noma and a final miscellaneous chapter. Each contains many clinical and pathological photographs, has surgical comments scattered throughout, and has a text contain- ing both clinical and pathological information.

Superficial reading of this book suggests that it will serve its purpose of providing information about the pathology of the breast to surgeons. A comment from a junior pathologist who had previously trained as a sur- geon was that it would be fine for FRCS candidates. How- ever, the advent of screening has meant that many more surgeons are becoming involved in the management of breast disease, and so it is an ideal time to ensure that current concepts and terminology are up to date.

The diagnostic methods section is presented in a dis- sociated manner. Flow diagrams to show the possible approaches in relation to the clinical problem would be of value. Handling of mammographic abnormalities, mark- ing of excision margins, reporting of FNAs, and the advantages of fresh tissue are areas which would have benefited from expansion and explanation.

The section on benign lesions shows a lack of insight into the present thoughts about differences between physiological and pathological changes, concepts which