The person to whom I think Renal Biopsy Interpretation isideally suited is a pathologist who for the first time takes upa post which carries full responsibility for reporting renalbiopsies. It may also appeal to general pathologists whooccasionally have to report a renal biopsy. If the algorithmapproach appeals, it will provide sensible and authoritativeadvice to steady the nerve through the initial learning curve.

P. N. FLeicester General Hospital

Atlas for Cardiovascular Pathology. Atlases in DiagnosticSurgical Pathology.R. V, A. F and A. B. Contribution by J. B.A. W. B. Saunders, Philadelphia. No. of pages: 224.Price: £124.

With autopsy, cardiac and vascular pathology being wellcovered in standard texts, the authors of this atlas have aimedto meet the real need for a well-illustrated reference book tosupport the relatively new and growing discipline of surgicalpathology of the cardiovascular system. The book consists ofsix sections comprising endomyocardial biopsy, pathologyof native and prosthetic cardiac valves, surgical pathology ofcardiac masses, diseases of the pericardium, diseases of thegreater vessels and pulmonary circulation, and finally, diseasesof the peripheral vessels. This means that the pathologicalentities are discussed essentially organ by organ, which isa successful format. A section on cardiac and pulmonaryvascular explant pathology would have contributed to thebook, since cardiothoracic transplantation is increasing anddeveloping in new centres.Several of the sections begin with an ‘approach to . . .’

chapter, which is particularly useful for those pathologistsencountering cardiovascular surgical pathology for the firsttime. The best of these introductory chapters are in the sectionson endomyocardial biopsy and on the pathology of native andprosthetic cardiac valves. The introductory chapters lendthemselves to headings with ‘bullet’ lists followed by selectedillustrations, but the separation of text and photographs worksless well in the other chapters. There is some unnecessaryduplication in the sections on diseases of the great vessels andperipheral vessels. The descriptions of some of the entities andclinical details varies between these two sections withoutexplanation, as in the case of giant cell arteritis.The term ‘atlas’ is interpreted in different ways by different

authors. I would have preferred to see the emphasis on picturesrather than text, but in this book, text dominates. Forexample, in the chapter on endomyocardial biopsy in thenon-transplant setting, there are as many pages of text as thereare illustrations. The endomyocardial biopsy of cardiacallografts and transplant atherosclerosis is reasonably welldescribed, but is illustrated with only 22 figures, giving insuf-ficient coverage for a practising cardiac transplant pathologist.The section on pulmonary hypertension is rather short,with too few illustrations to be of use in assessing cases ofunexplained pulmonary hypertension. The authors’ aim toproduce a useful reference book with ample illustrations hasbeen met in part, but it is more of a well-illustrated textbookthan an ‘atlas’.Whether an ‘atlas’ or not, the picture quality with modern

production methods should be of a more uniformly highstandard than this volume achieves. Several photomicrographshave unacceptable yellow or blue backgrounds which areparticularly noticeable on double spread pages of illustrations.There are also a fair number of black and white gross pictures,which would have benefited from being in colour for the sakeof uniformity. The legends of the figures are not always

adequate, with the reader having to refer back to the previouspages of text. This could have been largely avoided by eitherinterspersing the figures with the text, or simplifying the textand having more description and differential diagnosis in thelegends.When I first received the book for review, I was rather

disappointed for the reasons given above, but having workedmy way through the book systematically and having used it forthe reporting of specific specimens, I found the informationeasy to access. I particularly enjoyed using the sections onvalves, cardiac masses, and pericardium.The book would certainly be a useful addition to the

reporting room library, particularly for use by trainees. Theyshould also find a great deal of interesting pathology toenhance their post-mortem examination of the cardiovascularsystem. The organization of the text into headings, lists, andtables could be a very useful template on which to organizetutorials or lectures for trainees, both in pathology and in thecardiothoracic specialties. Trainees in both cardiology andcardiac surgery will find this book of value; the balance of textto figures may be more to their taste than to that of thehistopathologist!

S. SPapworth Hospital NHS Trust

Essential Clinical Pathology.D V. P (Ed.). Blackwell Science, Oxford, 1996.

The preface to this book states that it originates from thecombined pathology course at Oxford University ca. 1991–1993 and that it is written in ‘spirit of the changes in medicaleducation, the new core curriculum and evidence basedmedicine’. Does this undergraduate pathology textbook boldlygo where no pathology textbook has gone before?In common with many recently introduced undergraduate

texts, it has soft covers and is attractively presented. It islavishly illustrated throughout with colour specimen photo-graphs and photomicrographs which are, in general, of excel-lent quality. Unfortunately, the electron micrographsillustrating glomerulonephritis in Chapter 21 (a topic thatstudents invariably find difficult) are a bit small and lacking incontrast. Full colour cartoons are also interspersed throughoutbut their purpose was lost on me and eventually I began to findthem rather annoying.The first section of the book is an introduction to the

laboratory specialities. This works well and contains lots ofinformation that would be useful to senior clinical students.The third and last section of the book. ‘Essential SystemicPathology’, is very comprehensive and successfully interweavesthe relevant chemical pathology and microbiology, at leastfrom the perspective of the histopathologist! There aretables describing the pathological causes of symptoms such asdyspnoea and the occasional CT scan and ECG.I found the second section of the book, entitled ‘Essential

General Pathology’, both disappointing and confusing. Thepreface states that it deals with disease processes involvingmultiple systems, which is true enough, but it does not providea balanced account of fundamental disease processes, or to usethe traditional terms, basic or general pathology. Whilst thereis a detailed chapter on the immune system and immuno-deficiency, there is no explanation of inflammation. The chap-ter on neoplasia is poorly written and incomplete—I could notfind a single reference to tumour suppressor genes.This book, then, provides a comprehensive review of system-

atic pathology and throws in a lot of integrated microbiologyand chemical pathology. As a bonus, it is almost atlas-like inits illustrations. The book will be of most use to the more

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senior clinical students, as it does not provide an account ofgeneral pathology. The spirit of the new core curriculum isevident but I am surprised to hear that the authors wereallowed to teach pathology, as it seems that teaching and-ologies are banned and we should now be facilitating studentenquiry into abnormal structure!

D. T. MMRoyal Group of Hospitals Trust andThe Queen’s University of Belfast

Contemporary Issues in Surgical Pathology. Pathology ofLymph Nodes.L M. W (Ed.). Churchill Livingstone, Edinburgh,1996. No. of pages: 453. Price: £75.00.

In the preface to this volume of Contemporary Issues inSurgical Pathology, Lawrence Weiss makes it clear that this isnot intended as a comprehensive text on haematopathology.Instead, the book aims at providing an in-depth coverage of alimited number of important topics. In practice, the 17 authorscover a wide range of topics in 11 chapters. There is an openingchapter, giving an up-to-date account of molecular haemat-opathology with details of the techniques used, followed byfindings in all the major categories of lymphoma. There followexcellent and authoritative chapters on reactive lymphaden-opathies and separate chapters on classical Hodgkin’s diseaseand nodular lymphocyte predominant Hodgkin’s disease.While the importance of classic Reed–Sternberg cells in defin-ing and classifying Hodgkin’s disease is not disputed in the erabefore immunohistochemistry came into widespread use, it isrefreshing to read the statement by the authors of the chapteron classical Hodgkin’s disease: ‘We believe that a diagnosis ofHodgkin’s disease may be rendered on the basis of Reed–Sternberg variants, even in the absence of classical RS cells. . .’. A few years ago, that statement would have earned theauthors a fatwa.There is a brief chapter on the classification of non-

Hodgkin’s lymphoma that includes discussion of the REALclassification. The need for this is apparent, with a number ofthe chapters suffering from the obfuscation of Working For-mulation terminology. The remaining chapters include anexcellent account of low-grade B-cell lymphomas and a chap-ter on diffuse, aggressive non-Hodgkin’s lymphomas. Thechapter on peripheral cell lymphomas contains a large amountof data but does little to clarify this complex group oflymphomas. There is a valuable chapter on post-transplantlymphoproliferation disorders, a chapter of Ki-1 positivelarge cell lymphomas (anaplastic large cell lymphoma), and afinal, interesting chapter on histiocytic and dendritic cellproliferations.The illustrations in this book are in black and white and

most are of a high standard. The chapters are well referenced,up to 1995, making this a valuable source book for the nextfew years. Haematopathologists will undoubtedly find thisvolume of interest. If, however, you are looking for a diagnos-tic text, buy the AFIP Fascicle.

D. H. WSchool of Medicine

Southampton University Hospitals Trust

Cells, Tissues and Diseases. Principles of General Pathology.G. M and I J. Blackwell Science, Oxford,1996. No. of pages: 974.

Somewhat irrationally, I am impressed by big books and thisone weighed in at a satisfactory 2·88 kg, measured

278#215#47 mm, and has 974 pages bearing 1074 illus-trations. I quite liked the cover—obviously a picture of anendothelium en face with adherent lipid droplets. So far, sogood and then I opened the book and found a detailedexplanation of the cover illustration—it is a pun on the title ofthe book. My heart sank. A pun which required a detailedexplanation seems barely worth the effort. My spirits wererestored, however, on reading the preface, which contained arobust defence of the science of general pathology. I gleefullynoted (for future use in my department) the statement—‘Asregards the bacteriologists and immunologists, their speciali-ties were taught as part of pathology only a few decades ago.When they branched off, they also sawed themselves off fromthe main trunk and dropped all connections with the study ofdisease.’The authors are not modest in the scope of the clientele

which they hope will be attracted to their book—‘all pathol-ogists, as well as physicians, all teachers of pathology, path-ology residents, inquisitive medical students, biologists,including college teachers, molecular biologists, immunolo-gists, bacteriologists, physiologists, researchers, graduatestudents and basic scientists’! There is nothing wrong withambition, but the reality is that not all these groups will rushout to buy this book.In the preface the authors pose a fundamental

question—‘Why another General Pathology textbook?’ Why,indeed, and I am not sure that the authors give an entirelyconvincing answer. Their ambition is to produce a booksuitable for medical and non-medical readers and which would(i) focus on the cell as the ‘elementary patient’, (ii) emphasizeprinciples, (iii) use the historical approach, (iv) use illustrationsintegral to the message, (v) emphasize that the manifestationsof disease can be found in all walks of life, (vi) tell a singlestory from beginning to end, and (vii) try to cope construc-tively with the literature explosion. There are, of course, anumber of distinguished textbooks currently available whichcould lay claim to any or most of these attributes. I like thehistorical approach, but it is not to everyone’s taste. I alsoenjoy illustrations which are integral to the message and thenew line drawings in the book are generally excellent. Thequality of some of the other illustrations, however, is quitevariable—it is very difficult, for example, to interpret Figure1.2 and the publishers need to pay attention to the black andwhite pictures throughout.The book has five main subdivisions—Cellular Pathology,

Injury and Inflammation, Vascular Disturbances, Immuno-pathology, and Tumours. All are well written and informativeand I would single out Injury and Inflammation and VascularDisturbances as being truly excellent. In terms of the potentialreadership, the book is likely to be of most benefit to thosewithout formal medical training who have a particular needand desire to obtain an intellectual framework in generalpathology.We are informed that the book is the product of conjugal

enterprise and, as such, is of ‘single authorship’. It seems thatthe enterprise was herculean in scope and consumed a largequantity of cellulose. One is reassured to be told that 101 treeshave been planted in compensation. The end result is a literarystyle which is certainly individualistic. I found it very readable–others may not. Books with a single or a limited number ofauthors are sometimes accused of lack of balance. Looking atthe section on pathological calcification (a topic often dealtwith in a superficial naive fashion), I found the treatment to bereassuringly quite sophisticated. Overall, the book evidences awelcome integrating approach. One of the most telling illus-trations is the first (Figure P-1). This shows the eight levels(genes]populations) at which diseases may be studied. Nowa-days we are so focused at genetic and molecular level that it

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