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CYTOPATHOLOGIC DIAGNOSIS of SEROUS FLUIDS
Vinod Shidham (Editor)
Lester J Layfield (Co-editor)
The preface to the second edition by Dr. Ruth Katz is summarized here. This book provides an essential tool to aid in the diagnosis of serous effusions. It is lavishly illustrated. The chapters have been authored by experienced and expert pathologists of international repute with detailed cytologic descriptions. They are well organized with a comprehensive list of references. There are tables containing an algorithmic approach to the diagnosis of different entities throughout the book. It is both practical as well as extremely comprehensive and is strongly recommended for cytology professionals from beginning students to the most experienced practitioners. Overall this second edition, while quite similar to the first edition, has extra images with updated immunohistochemistry and molecular pathology.
The first twelve chapters are devoted to topics, ranging from benign reactive effusions, common metastatic carcinomas, and mesothelioma to the more unusual and rare non-epithelial neoplasms and hematolymphoid disorders. The last three chapters are more technical and provide guidelines for the use of flow cytometry to diagnose lymphoproliferative infiltrates in effusions, including tables describing major molecular genetic abnormalities found in lymphoma, acute leukemias, and soft tissue tumors.
Each chapter demonstrates classic examples of different neoplasms with their characteristic architectural and cellular features, easily relatable to the diagnostic cytologist. Examples of different entities are clearly displayed using both Giemsa and Papanicolaou stains. In addition, the use of cell-block tissue stained with H and E is commonly used. cell-blocks are essential to perform in order to refine the malignant diagnosis so that the precisely targeted therapy or biological therapy may be used.
The chapter dedicated to peritoneal washings cytology is an essential read with an excellent overview of the topic, including the pitfalls. The chapter covering hematolymphoid disorders is a comprehensive review of both benign and malignant lymphoid proliferations involving the serous cavities but also includes rare but important conditions. It also covers the differential diagnosis of non-neoplastic causes of effusions such as Tuberculosis. Cytomorphology and immunophenotype by both ICC and flow cytometry are covered with useful comments detailing differences from what one would expect to see in a tissue section or direct FNA smear.
Throughout the book and in different chapters there are examples of reactive mesothelial proliferations and adenocarcinomas that could also be confused with the cytologic appearance of certain subtypes of mesothelioma. A useful algorithm is provided that includes updated molecular pathology information to be used in making a definitive diagnosis of mesothelioma.
Another important chapter on appropriate specimen handling and optimal preparation. This chapter also details optimal specimen processing methods including direct smears, liquid-based cytology preparations, Cytospin, and filter preparations. Highly useful protocols for the different commonly used stains such as Romanowsky stains, and Diff-Quik stains are presented in tabular form. In addition, an extremely comprehensive catalog of cell-block techniques is provided including the use of Histogel, gelatin, agar, plasma-thrombin, collodion bag embedding, and Nano NextGen CelBloking™ kits. This chapter also outlines the 5 tier reporting system recently described for serous fluids.
The final chapter provides in-depth information regarding methods for ICC, and commonly used and less commonly used immunomarkers for diagnosing different malignancies, which are richly detailed regarding their derivation, which clones to use, and methods for antigen retrieval.