Diagnostic Cytopathology

Following Chandra Grubb's two previous excellent 'Atlas's of Cytopathology', this new book has been awaited with great interest. Dr Grubb writes extremely well and with her wealth of experience and meticulous care for detail, this book is of interest to the experienced cytopathologist as well as an essential book for every cytology laboratory both for MLSOs and junior doctors in training for their MRCPath examinations. Perhaps it is disappointing that there is no general chapter on FN aspiration technique, preparation of smears, together with various staining methods, their advantages and disadvantages and the essential part these play in correct interpretation. However, the special staining techniques are illustrated in the chapters in which they might prove useful. It would also have been an advantage to include the use of immunocytochemistry in cytological diagnosis as this is now becoming an important adjunct to conventional methods of staining now used in most cytology departments. The chapter on the female genital tract shows little new but the microphotographs are of high quality and there is a good picture ofchlamydia which will help cytoscreeners to identify this infection. Another excellent feature is the pictures and text on the various types of ovarian cyst fluids; these are now aspirated at laparoscopy and it is important that they should be identified. The description should prevent a false positive diagnosis. In chapter two the photographs and text of carcinoma of the breast are good, but it is a pity that with the modem terminology of benign breast change (fibrocystic change) and the degrees of hyperplasia rather than epithelioses and adenosis that a new book should still use the old terminology. The chapter on the respiratory tract is excellent. The microphotographs of the pathogens are particularly useful. It is rare to see Nocardia and therefore to have pictures of this, the fungi, Cryptococcus and Pneumocystis will be of considerable help to the inexperienced cytopathologist in the identification of these organisms. The microphotography of herpes simplex, again draws attention to the ease with which this may be confused with squamous cell carcinoma of the bronchus. Microphotographs of the various types of metastatic carcinoma are useful. Effusions are well covered with good pictures of the various mesothelial proliferations and types of atypia seen. These will help to avoid confusion with carcinoma. Microphotographs of many types of metastatic carcinoma are included as well as types of lymphoma and myeloma. The short chapter on CSF perhaps covers most essentials but comparison between a reactive picture and lymphoma is neglected. The chapters on oesophageal intestinal tract and liver are adequate. However, microphotographs of the pancreas, now an important area of FNA, under CT scan or ultrasound are not up to the excellent standard of those in other chapters of this book. The chapter on the urinary tract includes urine examination as well as FNA of kidney. The examination of the urine demonstrates cell changes on viral infections and ovum from tapeworm and schistosomiasis. The chapter on lymph node aspirations is scanty. This would have been an ideal place to include an extensive section on the lymphomas. However, it is not possible to cover completely the whole ofcytopathology in one small text book. In spite of a few chapters that perhaps should have been enlarged, it is a useful book and should be included in the library of cytology departments. O.M. Curling, Department of Cytology, St Bartholomew's Hospital, London ECIA 7BE