BOOK REVIEWS

Lack EE. Atlas of Tumor Pathology: Tumors of the Adrenal Gland and Extra-Adrenal Paraganglia, Third Series, Fascicle 19. Washington, DC: Armed Forces Institute of Pathology, 1997,468 pp , $70.00.

To write a monograph with the scope of this fascicle is a daunting task. The adrenal medulla and cortex are in many respects separate organs, each worthy of its own fascicle. In addition, the extra-adrenal paraganglia are anatomically and conceptually diffuse. The adrenal medulla and other sympathetic paraganglia are similar and dissimilar to their parasympathetic counterparts, and there are important, often subtle, diagnostic and clinicopathologic considera­tions associated with lesions in different anatomic sites.

Dr Lack has done an admirable job piecing these topics together. An excellent concise summary of the develop­ment, anatomy, and physiology of the adrenal gland is fol­lowed by equally outstanding chapters on diseases of the adrenal cortex, metastatic tumors , adrenal medullary hyperplasia, and pheochromocytoma. The extra-adrenal sympathetic and parasympathetic paraganglia are then dealt with collectively and separately. A concluding chapter discusses neuroblastomas and related tumors.

Several unusual topics make for particularly interest­ing reading. These include a discussion of the problems posed by "incidental" adrenal cortical nodules discov­ered at autopsy or in vivo. There is also excellent cover­age of tumorlike lesions, including cysts, hemorrhage, and infection.

The book is beautifully illustrated, with most figures in color. Numbered figures total about 600, but most of these are composites. The actual number of figures is therefore closer to 1,000, making this one of the most richly illustrated fascicles. Included are numerous anatomic drawings, schematic diagrams, gross photographs, and light and electron micrographs illustrating even extraor­dinarily rare tumors. Examples of diagnostically useful immunohistochemical stains and fine-needle aspirates complement examples of routine histopathologic fea­tures. Side-by-side comparisons of paragangliomas with diagnostic mimics, such as alveolar soft part sarcoma and

Rosen PP, ed. Rosen's Breast Pathology. Philadelphia, Pa: Lippincott-Raven, 1997,907 pp, $259.00.

This newest reference text on diseases of the breast is aptly titled, as it represents a compilation of the extensive experience of an expert in the field, as well as his interpreta­tion of the literature on breast pathology. In his acknowledg­ments of those who assisted him in producing this text, Dr Rosen mentions that the book is the product of almost 10 years of work. It was time well spent. Given the daunting challenge of one person producing a comprehensive text in a complex subject, Dr Rosen has succeeded admirably.

middle ear adenoma, should be very valuable. The dis­cussion of histopathologic features is also complemented by an outs tanding collection of clinical i l lustrat ions, including magnetic resonance and computed tomograph­ic scans and other imaging studies and photographs of patients with lesions in situ. An intraoperative photo­graph that shows an astonishing array of hemostats pro­truding from the field vividly attests to the vascularity of paraganglionic tumors. Illustrative material is accompa­nied by extensive clinicopathologic and pathophysiologic information with numerous up-to-date references.

Because of the exceptional completeness of this book, some information might be disproportionately weighted by the reader for diagnostic purposes. For example, in dis­cussing the perhaps little-known fact that pheochromocy-tomas have been reported to express immunoreactivity for cytokeratins, the text may obscure the point that extensive expression of common cytokeratin isoforms by these tumors is, at most, uncommon and should cast doubt on the diagnosis. However, the advantages of comprehensive references far outweigh this concern.

One minor criticism is that the various competing sys­tems for classification and grading of neuroblastic tumors are not readily deciphered and compared in the final chap­ter. Additional tables or diagrams might have been helpful for this purpose. A second minor disappointment is that the index does not do justice entirely to the enormous amount of information in the text. For example, although Dr Lack commendably illustrates unusual entities, such as oncocytic and pigmented paragangliomas, the only way to find some of the illustrations is by flipping pages.

Any minor flaws are overshadowed by the overall suc­cess of Dr Lack's endeavor. This book is a superb contribu­tion to its field and a valuable resource for readers with any level of expertise. It is also bargain priced. I recommend it enthusiastically for all pathology libraries.

ARTHUR S. TISCHLER, MD

Department of Pathology Tufts University, School of Medicine Boston, Massachusetts

This text is nothing if not complete. Every aspect of breast pathology is covered in the 50 chapters. The first 4 chapters discuss the embryologic development and normal anatomy of the breast, physiologic changes, developmental abnormalities, and inflammatory and infectious processes. These are followed by sections on benign papillary tumors, myoepithelial neoplasms, adenosis and microglandular adenosis, and fibroepithelial tumors.

The next two chapters, on ductal hyperplasia and precan­cerous breast lesions, are particularly well done and informa­tive. The opinions and criteria of other experts are reviewed, and Dr Rosen discusses his approach to the separation of

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