Cytology of Soft Tissue Tumours


M Ackerman, HA Domanski
Published by Kargar  (2003)
ISBN: 3-8055-7594-7    108 pages
RRP: US$134.00


This monograph is the distillation of 25 years of experience encompassing over 3,000 cases of the cytological diagnosis of soft tissue tumours from a specialist referral centre in Lund, Sweden.   The book is part of a series of monographs in clinical cytology edited by the ‘father’ of fine needle aspiration (FNA) cytology, Svante Orell.  The two authors, Mans Akerman and Henryk Domanski, have extensive experience in the FNA diagnosis of these tumours. 

Many anatomical pathologists in this country would baulk at the prospect of diagnosing soft tissue tumours through FNA.  The large number of different entities, their relative rarity and the existence of benign ‘mimics’ of malignant tumours make this a difficult area of diagnostic pathology at the best of times.  The loss of architectural information that occurs when a lesion is sucked up a 22-gauge needle and then smeared on a slide, as well as the inherent sampling problems of large tumours means that most pathologists will insist on at least a few core biopsies before venturing an opinion.  However, the ever-expanding number of publications on this topic and the push for less invasive methods of diagnosis means that the primary diagnosis of soft tissue tumours is emerging as an important new target for FNA.  The authors acknowledge these concerns and emphasise the need for a multidisciplinary approach, specifically, correlation with clinical and radiological data.  The book also details the numerous ancillary methods available for FNA material such as immunocytochemistry, electron microscopy, cytogenetics and DNA ploidy analysis.

At just over 100 pages, this hardcover book is somewhat slimmer than others in the series.  However it maintains the high standards set by those preceding it.   It is superbly illustrated with large, high-quality colour photomicrographs on almost every page.  These stand out in contrast to many recent pathology texts that have used digital images with less than optimal results.  Information on individual entities is very well presented with a description of the cytologic features, an adjacent summary of the pertinent features, and numerous tables comparing and contrasting features of entities within the differential diagnosis.  The text is concise and not dogmatic.  The overall organisation is excellent and the book is very easy to use.

This book deals with a highly specialised field within diagnostic cytology, a field that many cytopathologists are not comfortable or confident with. Its outstanding presentation and intelligent discussion make it a worthwhile reference for any cytology department which may potentially receive such specimens.  Furthermore, for those who just want a complete set of this notable series, it’s worth it!

Michael Buckland
Royal North Shore Hospital, NSW

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