Book Review

Paediatric Surgical Pathology: An illustrated handbook of the paediatric biopsy

N Engl J Med 1996; 335:1326-1327October 24, 1996

Article

Paediatric Surgical Pathology: An illustrated handbook of the paediatric biopsy
By Elizabeth S. Gray and Nicholas M. Smith. 204 pp., illustrated. New York, Churchill Livingstone, 1996. $120. ISBN: 0-443-04122-9

The title conveys clearly and accurately the nature and purpose of this book. It is intended for the pediatric surgical pathologist, and its place is next to the microscope. The pages are high in quality and plasticized, so they should withstand years of use and perhaps even some spattering. The price may seem high, but it is acceptable because the text is extensively illustrated with photomicrographs, all in color except for the few (four) electron micrographs. The helpful diagrams and tables on a number of topics clarify complex concepts.

Of the 13 chapters, 11 take up systemic (e.g., respiratory, gastrointestinal) or regional (e.g., head and neck, skin) pathology, 1 deals with small-cell tumors of childhood, and the last with lesions of soft tissues. Disorders confined to adults are excluded, and those that are very rarely seen in patients under 20 years of age, such as malignant melanoma, are only briefly noted with no illustration. Numerous topics of purely or mostly pediatric interest are covered extensively — i.e., retinoblastoma, lungs, mal-absorption syndrome, aganglionic megacolon, and many others. However, don't expect to get the amount of help here that you might want in evaluating a renal biopsy or the bone marrow for leukemia. Endomyocardial biopsy is never mentioned. Bronchopulmonary dysplasia is not alluded to, presumably because the authors receive no surgical specimen thereof, although persistent interstitial pulmonary emphysema is illustrated. Another neglected term is “aggressive fibromatosis.” Although there are several brief references to this type of lesion in various systems, the closest the book comes to covering it is (under “soft-tissue lesions”) in its discussion of infantile desmoid-type fibromatosis.

Even without referring to the title page we know that the authors are British, from their use of the diphthongs ae and oe, and of s in place of the accustomed (in the United States) z — e.g., “paediatric,” “oesophagus,” and “metastasise.” This is easy to adapt to. Less easy are the abbreviations. This book was written for the abbreviation lover. Just about everything is abbreviated. Most of the abbreviations are defined in the text and can be found with some effort by looking through the index. But when the reader forgets the meaning of the abbreviation a page or two later, it becomes necessary to refer to the preceding text or the index. A few abbreviations are assumed to be in such common use as to be undefined, such as EMA (epithelial membrane antigen), NSE (neuron-specific enolase), and GFAP (glial fibrillary acidic protein). An alphabetical glossary of abbreviations in the appendix would have been helpful.

This is an excellent first working reference book for pediatric surgical pathologists. Don't discard your other specialized reference works, however, since they will sometimes be needed for further details.

Charles B. Reiner, M.D.
Columbus Children's Hospital, Columbus, OH 43205