Pathology (October 2005) 37(5), p.
401
BOOK REVIEWS
Pathology of Pediatric Gastrointestinal and Liver Disease PIERRE RUSSO,
EDUARDO D. RUCHELLI, DAVID A. PICCOLI, EDITORS. Springer, New York,
2004. ISBN 0-387-40654-9, Hardcover, pp xiv+358, US$299
This book is unusual in combining both gastrointestinal and liver diseases
of childhood. It is divided into two sections dealing with each of these
disorders. Both sections start with excellent chapters on developmental
anatomy, and anomalies of the gastrointestinal tract and liver and biliary
tree, respectively. The gastrointestinal section also includes a valuable
section on the involvement of abnormalities of the gastrointestinal tract
with major malformative syndromes which is extremely helpful.
The authors of the respective chapters have been carefully chosen by the
editors of this book as leaders in their fields. For those involved in
paediatric pathology and clinical practice, the majority of the names are
well recognised as people we refer cases to or are respected lecturers at
seminars we have attended. Each chapter deals with the disorders from
both clinical and pathological points of view, enabling good correlation
and interpretation. They provide both clinicians and pathologists with
pertinent questions to ask and extra information to enable them to make
diagnoses. One of the delights throughout the book is the presence of tables
which cover diagnostic criteria, patterns of diseases, disorders associated
with particular changes and other manifestations of particular disorders.
These tables stand out in a different colour on the page and are easy to
read, refer to and follow. The majority of the photographs are colour and
of good quality and clarity which is enhanced with glossy paper. The
occasional black and white photographs are mainly at a higher power and
easily interpreted. Macroscopic photos are colour and present in those cases in
which they are pertinent. Diagrams are used occasionally to good effect.
As the authors are experts in their field, the chapters include the latest
molecular and genetic information available. The chapters on metabolic
and the cholestatic diseases of the liver certainly benefit from this.
There is some mild variability in information in chapters due to the
different authors and occasional editorial mistakes are present. There are
occasional areas where I would have expected more detail on common
childhood diseases, such as hepatic cystic fibrosis and graft versus host
disease in the gastrointestinal tract, however overall these are very minor
compared with the detail and information available on both common and
rare disorders. The book deals with diseases from a paediatric perspective
which avoids conditions not seen in childhood but does deal with the early
and childhood manifestation of adult diseases.
I would highly recommend this book to anyone working in clinical or
pathology practices which involve pediatric gastrointestinal and liver
disease. This is a valuable asset to the Library in our Department and has
been used on a regular basis since receiving it for review.
Susan Arbuckle
Histopathology Department, The Children’s Hospital at Westmead,
Westmead, New South Wales
Pathology of Melanocytic Nevi and Malignant Melanoma: 2nd
Edition RAYMOND L. BARNHILL, MICHAEL PIEPKORN, KLAUS J. BUSAM,
EDITORS. Springer, New York, 2004. ISBN 0-387-40326-4, Hardcover,
pp xiv+406, US$189
It was a pleasure to review this second edition to the original book edited
by Barnhill in 1995. In 12 chapters the authors comprehensively discuss and
describe the myriad of melanocytic lesions and very importantly offer
simple diagnostic criteria for most of these.
The first two chapters outline the pathology of melanocytes and discuss
tissue processing, immunohistochemistry and ancillary studies. The third
ISSN 0031-3025 printed/ISSN 1465-3931 # 2005 Royal College of Pathologists of Australasia
DOI: 10.1080/00313020500259841
chapter is new and has an excellent discussion of the genetic and molecular
pathology of melanoma by Michael Piepkorn. The final two chapters
describe metastatic melanoma with a discussion of sentinel node biopsies
and pitfalls in diagnosis, and the prognostic factors in cutaneous malignant
melanoma, which includes a thorough review of recent literature.
Seven chapters, divided into diagnostic categories, systematically discuss
the many different benign and malignant melanocytic lesions. For each
entity this includes a discussion of clinical features, histopathological
features and differential diagnoses. Unlike other texts on melanocytic
lesions, the authors give concise diagnostic criteria for most entities which
is of great benefit to the practising pathologist. The majority of entities are
summarised in tabulated form with descriptions sufficient for most day-
to-day reporting, however some diagnostic gems remain hidden in the text.
The differential diagnostic sections are particularly useful, concisely
describing differentiating criteria. The text also includes over 250 well-
annotated and instructive colour photomicrographs.
The text does include some controversial ideas. The authors believe that
the term ‘lentigo maligna’ has become a wastepaper basket for any
lentiginous lesion arising in sun-damaged skin, ranging from benign
melanocytic hyperplasia of chronically sun-damaged skin to melanoma
in situ. They contend there is a spectrum of intraepidermal melanocytic
proliferations of sun-exposed skin and offer a well-defined categorisation
into solar melanocyte hyperplasia, solar lentigo, solar lentiginous naevi,
solar intraepidermal melanocytic proliferation with atypia and melanoma
in situ. I believe the adoption of this reclassification would simplify the
histological diagnostic process and aid clinical decision making but it does
not appear to have wide acceptance or knowledge by most pathologists or
clinicians as yet.
The authors also propose an overhaul of melanoma classification, with
separation into conventional melanoma, with a description of the
junctional component, and unusual variants. The conventional melanoma
group subclassifies acral lentiginous melanoma and lentigo maligna
melanomas but these are renamed acral and solar subtypes, respectively.
Superficial spreading melanomas become pagetoid melanomas in this
system. The separation of the types of conventional melanoma is largely
based on sun exposure – intermittent, chronic or none. Other more minor
changes in terminology are also suggested.
While overall I find this an excellent text, there are some shortfalls. The
most obvious is the quality of the photomicrographs. A surprising number
of these are of moderate quality at most, with the low power shots
particularly appearing faded and sometimes out of focus. There are also
many typographical errors, some of which are quite amusing: ‘respectable
metastases’, ‘solar intraepidermal proliferation with sepia’ and ‘atypical
nervi’. In one instance ‘melanoma’ replaces ‘melasma’. There are some
diagnostic areas I would have liked covered in more depth such as
assessment of residual dermal melanocytic lesions in areas of regression, a
more detailed discussion of deep penetrating naevi, a concise discussion of
histological features of naevi in children and mitotically active dermal
naevi, but these are minor issues in a very thorough review of melanocytic
lesions.
A non-pathologist medical colleague of mine saw this book and couldn’t
believe there could be such a tome ‘just on moles’. I am very happy that it
does exist and recommend it to any surgical pathologist as an invaluable
part of our armoury against melanocytic lesions.
Elizabeth Barr
Department of Histopathology, Mayne Health Laverty Pathology,
North Ryde, New South Wales