Thursday, 19 September 2013

Brain tumor pathology: Current diagnostic hotspots and pitfalls

This monograph by an accomplished neuropathologist is centered largely on contemporary difficulties encountered in the histopathologic diagnosis of brain tumors. Particularly useful are his approaches to oligodendrogliomas and their anaplastic variants; distinctions among mixed astro-oligodendrogliomas, pleomorphic xanthoastrocytoma (PXA), and juvenile pilocytic astrocytoma; ependymoma and its anaplastic variant; differentiation of ganglioglioma from oligodendroglioma, dysembryoplastic neuroepithelial tumor, cortical dysplasias, PXA, and juvenile pilocytic astrocytoma; and pitfalls in overinterpreting anaplastic features in the latter tumor.
The author also covers newly identified neoplasms: liponeurocytoma, rosette-forming glioneuronal tumor, and chordoid glioma, as well as neoplasms of uncertain nosology, derivation, and growth (astroblastoma, capillary hemangioblastoma, gliomatosis cerebri, and chordoid glioma of the third ventricle). Other than meningiomas, nonneuroectodermal tumors (ie, schwannomas and chordomas, among others) are not discussed. Chapters on tumor cell migration and invasion, apoptosis, the ubiquitin proteasome system, and angiogenesis round out this volume.
Advantage is taken of the evolving field of molecular genetics, intracellular signaling mechanisms, and conventional immunohistochemical methods to arrive at a histopathologic diagnosis. The details provided using these methods are a major emphasis of this book and are of exceptional value.
All of the microphotographs are in black and white; most of these are satisfactory. For the uninitiated, however, some of the photographs might be challenging, because there are no arrows depicting items mentioned in the legends. The latter occasionally suffers from terseness, as at times it is unclear what is being illustrated. The addition of normal controls, especially with immunohistochemical photographs, would have been helpful. The photomicrographs are occasionally complemented by MR imagings and CT scans.
This readable monograph is highly recommended to surgical pathologists. It is likely to be of lesser value and interest to the neuroradiologist. For neuroradiologists interested in histopathology, especially with imaging correlations, other texts might be more suitable. On the other hand, discussions on glioneurogenesis, molecular genetics, growth factors, stem cells, and intracellular signaling mechanisms involved in the neoplastic process, along with extensive bibliographic annotations, should be of great interest and value to students of neuro-oncology.

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