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JOURNAL OF PATHOLOGY, VOL.
178: 233-234 (1996)
BOOK REVIEWS
Methods in Molecular Biology, Volume 34.
Immunocytochemical Methods and Protocols.
LORETTE
C. JAVOIS (Ed.). Humana Press. No. of pages: 435.
Price: $64.50.
This book is written for the research scientist, technologist,
and pathologist. Its aim is to provide wide-ranging and
in-depth information on techniques and protocols involved
essentially in the field of immunocytochemistry. The main
immunocytochemical topics are divided into seven sections
and include antibody preparation, tissue and cell preparation,
detection systems, fluorescence-activated cell sorter (FACS)
analyses, colloidal gold detection systems, photography, and
special applications.
Under antibody preparation, purification, conjugation, and
biotinylation are discussed, giving valuable information on
how to prepare immunological reagents. The tissue preparation section deals with fixation, cell preparation, frozen
sections, and routine processing. The technical detail given is
of value, especially for beginners in these areas. The light
microscopy detection systems include fluorophores, immunofluorescent, immunoenzymatic, silver, ELISA, and avidinbiotin labelling. The detailed techniques and the impressive
information on fluorophores are a great aid to anyone starting
out with these methods. The section on fluorescence-activated
cell sorter (FACS) analysis looks at many aspects of flow
cytometry and again gives valuable technical data. Part V deals
with colloidal gold detection in electron microscopy. Many
examples of resins are given, together with detailed immunolabelling techniques. The photomicrographs are excellent. The
section on fluorescence photomicrography, whilst brief, is
helpful to the beginner, although the lack of illustrations must
be considered a drawback.
The special techniques section is one of the best parts of the
book. However, not all of its content lies wholly in the
immunocytochemical domain. Chapters include fluorescence
analysis with the confocal microscope, laser microbeam applications as related to antibody targeting, nucleic acid immunocytochemistry (in situ hybridization), fluorescence in situ
hybridization using whole chromosome library probes, automated immunostainers, and immunocytochemical approaches
to the differential diagnosis of tumours. The detail given in all
of these chapters is of value. The last chapter, however, shows
a certain lack of authority and organization. The author insists
that surface staining of light chain immunoglobulins is not
possible on paraffin sections, when there are many publications
dating from as long ago as 1989, such as that of Norton and
Isaacson, contradicting this statement.
The lack of illustrations in some chapters is a weakness of
this book. Overall, however, it contains much that will be
helpful to the research worker, whilst also serving as a
worthwhile bench manual.
K. MILLER
UCL Medical School
London
Sudden Death in Infancy, Childhood and Adolescence.
ROGERW. BYARDand STEPHEND. COHLE. Cambridge
University Press, Cambridge, 1994. Price: E60.00.
Whilst there is considerable literature on the causes of
sudden death in adults and on the sudden infant death
01996 by John Wiley & Sons, Ltd.
syndrome (SIDS), the authors, noting a dearth of literature on
broader aspects of sudden death in infancy, childhood, and
adolescence, have decided to redress the perceived deficit. As
stated in the preface to the book, their goal was to provide
a comprehensive system by system review of a wide range
of entities, including both common and more arcane disorders, along with illustrations of the conditions and back-up
references for further reading.
The book extends to nearly 500 pages of text with 45 pages
of appendices and index. The succinct, relatively lucid prose
style is welcome. This does mean, however, that the descriptions of disease entities are of necessity brief and the reader
need not expect too much detail on pathogenetic mechanisms
or investigative techniques.
Approximately half the chapters cover what may be loosely
termed organ system pathology. The remaining chapters are
more broadly based and cover multi-system topics, such as
accidental and non-accidental trauma, metabolic disease, and
miscellaneous conditions. In consequence, information on a
given problem may be in either one section or the other, or
even both.
Particularly useful are the chapters dealing with accidental
and non-accidental injury. The latter covers aspects of child
abuse and Munchhausen’s syndrome by proxy and will be of
considerable help to pathologists faced with unusual pathological findings in a young infant or child in whom background
circumstances may suggest unnatural causative mechanisms.
The chapters on metabolic and endocrine disease and ‘miscellaneous’ conditions cover a mixture of diseases, some of
which, for example Marfan’s syndrome, may have been
referred to in the systemic area of the book. Many of these
diseases have by tradition been described in the ‘systemic’,
‘metabolic’ or ‘genetic’ areas of standard references, but are
now understood to be disorders of genetic information.
Authors at this time do have a problem in deciding in exactly
which chapter a particular disease should now be described.
The last chapter is a useful discussion on the problems of
SIDS, with comprehensive coverage of the aetiological and
pathological features. The authors indicate the importance of a
thorough and detailed death scene investigation and stress the
importance of not using the term SIDS as a diagnostic dustbin
until all possible avenues of investigation have been exhausted.
The chapter ends with a comprehensive, if relatively brief,
discourse on the possible causative mechanisms of SIDS.
Distributed throughout the book are a number of useful
tables detailing a wide range of pathological entities affecting
given organ systems, which can cause sudden death. These will
form useful checklists for pathologists before embarking on
individual autopsies. The book is written from an Australian
perspective and the medico-legal framework described, particularly in the appendices, is based on Australian jurisdiction.
In the appendices, protocols are detailed for the examination
of SIDS. These are of particular interest. They were agreed by
a group of pathologists involved in performing SIDS autopsies
and would be useful models to inform databases, to allow for
the analysis of complex epidemiological and pathological data
in the investigation of SIDS. The protocols recommend X-ray,
bacterial, viral, biochemical, and cytogenetic studies, inter alia.
These recommendations and the proposition that up to 23
different tissue samples be reserved for histological examination would no doubt raise the eyebrows of managers, some of
whom may even be pathologists, as they strive to impose
234
BOOK REVIEWS
‘cost-effective’(?cheap) protocols on those workers whose sole
interest is to undertake quality investigation, with the families
of patients in mind. Perhaps even more important may be the
raising of the eyebrows of some pathologists performing
autopsies on cases of sudden death in infancy and childhood, who may also wrongly imagine that the recommended
investigations are superfluous!
This book represents good value at E60.00 and will find a
place on the reference shelves of paediatric, general, and
forensic pathological laboratories.
M. D. O’HARA
The Queen’s University of BeEfast
Major Problems in Pathology Volume 33. Pathology of the
Thjwus and Mediastinunz
M. J. KORNSTEIN
and G. G. DE BLOIS.Published by W. B.
Saunders. No. of pages: 247. Price: E46.
Most specialist textbooks are based on an organ system or
disease. The contents of this book, however, are determined by
the boundaries of those spaces in the thorax included in the
mediastinum. Thymic epithelial neoplasms and high-grade
thymic B-cell lymphoma clearly fall within these spaces but
other conditions, such as Hodgkin’s disease, present more
commonly elsewhere in the body. This poses a problem for the
author as to whether conditions such as Hodgkin’s disease
should be dealt with in depth. The reader, faced with a possible
case of Hodgkin’s disease, might question whether he or she
would do better to turn to a textbook of haematopathology for
guidance, rather than a textbook on the mediastinum. Pathologists serving thoracic surgical units will probably find this book
of value. Its usefulness would, however, have been enhanced if
the authors had provided more detail on how to deal with and
interpret biopsies obtained at mediastinoscopy which frequently suffer traction artefact, particularly if they are fibrotic.
These problems may be compounded by emergency chemotherapy or other treatments for obstructive symptoms that
may precede the biopsy. The differentiation between nodular
sclerosing Hodgkin’s disease, high-grade thymic B-cell lymphoma, germ-cell neoplasms, and bronchial carcinoma may be
extremely difficult in such cases, demanding a combination
of interpretive skills, immunohistochemistry, and possibly
molecular biology. The balance between a misdiagnosis and an
unnecessary thoracotomy can be a fine one.
A test that I sometimes apply, when reviewing books, is to
ask what help they would have provided with difficult cases
that I have encountered over the years. A young woman with
myasthenia gravis and mastocytosis of the thymus, not mentioned, but it may have been a unique case. Extramedullary
haematopoiesis forming a mediastinal mass in a patient with
thalassaemia, not mentioned. Composite Hodgkin’s disease
and high-grade thymic B-cell lymphoma, not mentioned.
Despite failing this test, the text is generally well written, well
referenced, and up-to-date. It provides a detailed account of
the pathology of thymic epithelial tumours, mediastinal lymphomas, mediastinal germ-cell tumours, and neuro-endocrine
tumours, as well as a miscellany of other lesions that may
arise or present in the mediastinum. The illustrations are of
variable quality, although most are satisfactory. Despite its
limitations, this book will find a useful role in our reporting
room library.
D. H. WRIGHT
Professor of Puthology
Southumpton University Hospita1.r Trust
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