Endocrine Pathology: Differential Diagnosis and Molecular Advances
http://www.100md.com
《新英格兰医药杂志》
As in many areas of surgical pathology, the field of endocrine pathology is rapidly evolving from a purely descriptive discipline into one that is increasingly based on principles of cellular and molecular biology. Advances in our understanding of endocrine tumors over the past 25 years have been nothing short of extraordinary. To name but a few, these advances include the concept of the neuroendocrine system and its associated neoplasms, the roles of oncogenes and tumor-suppressor genes in the pathogenesis of endocrine tumors, and the role of molecular testing methods in the diagnosis of multiple endocrine neoplasia syndromes. In a multiauthored textbook such as this, the challenge for the editor and the authors is to amalgamate all of this information into workable clinical and pathological concepts. Lloyd and his colleagues have largely succeeded in achieving this formidable goal.
(Figure)
Macroscopic View of a Pancreatic Endocrine Tumor from a Patient with von Hippel–Lindau Disease.
Courtesy of Humana Press.
The introductory chapter provides a lucid and concise account of molecular methods, including in situ hybridization, polymerase-chain-reaction–based sequencing, comparative genomic hybridization, clonality analyses, and microarray-based methods. Along with immunohistochemistry, each of these approaches has become a fundamental part of the armamentarium of the contemporary endocrine pathologist.
The subsequent chapters provide comprehensive coverage of traditional gross and microscopical pathology, considerations to be incorporated into the differential diagnosis, and, most important, the molecular features of both neoplastic and non-neoplastic endocrine lesions. In some instances, Lloyd has included separate chapters that focus on molecular aspects of particular endocrine organs (e.g., the pituitary, the thyroid, and the parathyroid glands); most of the other chapters incorporate both standard pathological descriptions and relevant molecular and immunohistochemical data. The chapter on the molecular biology of the thyroid, for example, presents an in-depth discussion of the roles of RET/PTC rearrangements in papillary carcinoma, RAS mutations and PAX8-PPAR rearrangements in follicular cancers, RET mutations in medullary carcinoma, and RAS, p53, and -catenin mutations in poorly differentiated and anaplastic carcinomas.
The book also includes an excellent chapter on cytologic analysis with the use of fine-needle aspiration, an approach that is being used increasingly in patients with endocrine tumors. In addition, there are brief chapters devoted to the surgical, radiotherapeutic, and medical approaches to the treatment of patients with endocrine tumors. Each of the chapters is liberally illustrated with black-and-white photomicrographs, and many of the chapters also include useful diagrams and line drawings. Twelve pages of color plates are grouped in the center of the book.
In summary, Lloyd and his collaborators have provided a useful and well-organized resource designed not only for the endocrine pathologist and the general surgical pathologist, but also for the clinical endocrinologist and the endocrine surgeon.
Ronald A. DeLellis, M.D.
Brown University
Providence, RI 02812(Edited by Ricardo V. Lloy)
(Figure)
Macroscopic View of a Pancreatic Endocrine Tumor from a Patient with von Hippel–Lindau Disease.
Courtesy of Humana Press.
The introductory chapter provides a lucid and concise account of molecular methods, including in situ hybridization, polymerase-chain-reaction–based sequencing, comparative genomic hybridization, clonality analyses, and microarray-based methods. Along with immunohistochemistry, each of these approaches has become a fundamental part of the armamentarium of the contemporary endocrine pathologist.
The subsequent chapters provide comprehensive coverage of traditional gross and microscopical pathology, considerations to be incorporated into the differential diagnosis, and, most important, the molecular features of both neoplastic and non-neoplastic endocrine lesions. In some instances, Lloyd has included separate chapters that focus on molecular aspects of particular endocrine organs (e.g., the pituitary, the thyroid, and the parathyroid glands); most of the other chapters incorporate both standard pathological descriptions and relevant molecular and immunohistochemical data. The chapter on the molecular biology of the thyroid, for example, presents an in-depth discussion of the roles of RET/PTC rearrangements in papillary carcinoma, RAS mutations and PAX8-PPAR rearrangements in follicular cancers, RET mutations in medullary carcinoma, and RAS, p53, and -catenin mutations in poorly differentiated and anaplastic carcinomas.
The book also includes an excellent chapter on cytologic analysis with the use of fine-needle aspiration, an approach that is being used increasingly in patients with endocrine tumors. In addition, there are brief chapters devoted to the surgical, radiotherapeutic, and medical approaches to the treatment of patients with endocrine tumors. Each of the chapters is liberally illustrated with black-and-white photomicrographs, and many of the chapters also include useful diagrams and line drawings. Twelve pages of color plates are grouped in the center of the book.
In summary, Lloyd and his collaborators have provided a useful and well-organized resource designed not only for the endocrine pathologist and the general surgical pathologist, but also for the clinical endocrinologist and the endocrine surgeon.
Ronald A. DeLellis, M.D.
Brown University
Providence, RI 02812(Edited by Ricardo V. Lloy)