Diagnostic Pathology: Intraoperative Consultation, 2nd Edition

By Susan C. Lester, MD, PhD

ISBN: 9780323570190

Pub Date: 2/13/2018

Reviewed by: Alex Taylor, MD (University of Michigan Medical School)

Description

This is the second edition of a comprehensive review of frozen section interpretation and methodology. As part of the practical and esteemed Diagnostic Pathology series, this update of the first edition (2013) adds many chapters with new content while maintaining its unique organization by the specific clinical question being addressed during intraoperative consultation.

Purpose

This book is expertly designed to be an immediately approachable resource for answering specific intraoperative questions. The accessible format achieves this practical goal and also serves as a refreshing and engaging review for pathologists or trainees preparing to work on a frozen section service.

Audience

Suited for a variety of readers, this book is especially high-yield for practicing pathologists or pathologists in training on service wishing to be optimally prepared for the wide variety of questions and content areas required during intraoperative consultation.

Features

The book is split into three main sections. The first reviews general concepts regarding intraoperative consultation and real-world management (quality assurance, safety, etc.) of a frozen section laboratory. The second section goes into depth on both basic and advanced methodology required by the laboratory during consultation. The majority of the content is in the third section’s 60 chapters, each uniquely and practically based on a specific clinical question, for example, “Lung Mass: Diagnosis” or “Breast: Parenchymal Margins.” Each content area begins with an outline-formatted discussion of the main clinical context of evaluations and the important aspects of gross and frozen examination. The discussion then proceeds to briefly review (in 3-5 bullet points with more clarification when warranted) the most common diagnoses. Also included are important tips for reporting results as well as common pitfalls for challenging diagnostic distinctions (i.e. “lepidic pattern adenocarcinoma vs. non-neoplastic inflammatory changes”). Each area concludes with a series of relevant gross and microscopic images with informative captions and annotations. For sections with a broad differential, multiple pages of six-panel image arrays clearly and efficiently demonstrate important diagnostic features and learning points. These images (more than 1,700 in the book overall) are of the high resolution and quality that readers of the Diagnostic Pathology series have come to expect. This edition includes new chapters on lung wire localization biopsy, nipple margin evaluation, radioactive seed identification, and evaluation of neurological tissue for epilepsy. In addition, there is notable updated methodological information on preservation of biomolecules for molecular assays, assessing staple margins of lung wedge resections, and T-bar localization for lung biopsies.

Assessment

This update is a tremendously practical book for any surgical pathologist or pathologist-in-training and has use both as a scope-side reference and as a review for those preparing to rotate on to a frozen section service. The entire book is organized and formatted around the specific needs of readers during intraoperative consultation, making the book more like an expertly guided tour through a diagnostic question. It is also remarkably efficient at visually presenting a breadth of possible entities for a given diagnostic dilemma.

Multipage panels of photographs and captions give visually oriented readers opportunities for “picture matching” a case against various entities in the differential diagnosis as well as for broadly reviewing morphological patterns without having to wade through excessive clinical information. Because it is focused in scope and execution, this book stands out as an exceptional volume in the highly regarded Diagnostic Pathology series and is strongly recommended as an addition to any personal or departmental library.

Doody’s Review Service Weighted Numerical Score: 100 — 5 Stars!