JOURNAL OF PATHOLOGY, VOL. 178: 233-234 (1996)

BOOK REVIEWS Methods in Molecular Biology, Volume 34. Immunocytochemical Methods and Protocols. LORETTE C. JAVOIS (Ed.). Humana Press. No. of pages: 435.

Price: $64.50.

This book is written for the research scientist, technologist, and pathologist. Its aim is to provide wide-ranging and in-depth information on techniques and protocols involved essentially in the field of immunocytochemistry. The main immunocytochemical topics are divided into seven sections and include antibody preparation, tissue and cell preparation, detection systems, fluorescence-activated cell sorter (FACS) analyses, colloidal gold detection systems, photography, and special applications.

Under antibody preparation, purification, conjugation, and biotinylation are discussed, giving valuable information on how to prepare immunological reagents. The tissue prepar- ation section deals with fixation, cell preparation, frozen sections, and routine processing. The technical detail given is of value, especially for beginners in these areas. The light microscopy detection systems include fluorophores, immuno- fluorescent, immunoenzymatic, silver, ELISA, and avidin- biotin labelling. The detailed techniques and the impressive information on fluorophores are a great aid to anyone starting out with these methods. The section on fluorescence-activated cell sorter (FACS) analysis looks at many aspects of flow cytometry and again gives valuable technical data. Part V deals with colloidal gold detection in electron microscopy. Many examples of resins are given, together with detailed immuno- labelling techniques. The photomicrographs are excellent. The section on fluorescence photomicrography, whilst brief, is helpful to the beginner, although the lack of illustrations must be considered a drawback.

The special techniques section is one of the best parts of the book. However, not all of its content lies wholly in the immunocytochemical domain. Chapters include fluorescence analysis with the confocal microscope, laser microbeam appli- cations as related to antibody targeting, nucleic acid immuno- cytochemistry (in situ hybridization), fluorescence in situ hybridization using whole chromosome library probes, auto- mated immunostainers, and immunocytochemical approaches to the differential diagnosis of tumours. The detail given in all of these chapters is of value. The last chapter, however, shows a certain lack of authority and organization. The author insists that surface staining of light chain immunoglobulins is not possible on paraffin sections, when there are many publications dating from as long ago as 1989, such as that of Norton and Isaacson, contradicting this statement.

The lack of illustrations in some chapters is a weakness of this book. Overall, however, it contains much that will be helpful to the research worker, whilst also serving as a worthwhile bench manual.

K. MILLER UCL Medical School

London

Sudden Death in Infancy, Childhood and Adolescence. ROGER W. BYARD and STEPHEN D. COHLE. Cambridge

University Press, Cambridge, 1994. Price: E60.00.

Whilst there is considerable literature on the causes of sudden death in adults and on the sudden infant death

0 1996 by John Wiley & Sons, Ltd.

syndrome (SIDS), the authors, noting a dearth of literature on broader aspects of sudden death in infancy, childhood, and adolescence, have decided to redress the perceived deficit. As stated in the preface to the book, their goal was to provide a comprehensive system by system review of a wide range of entities, including both common and more arcane dis- orders, along with illustrations of the conditions and back-up references for further reading.

The book extends to nearly 500 pages of text with 45 pages of appendices and index. The succinct, relatively lucid prose style is welcome. This does mean, however, that the descrip- tions of disease entities are of necessity brief and the reader need not expect too much detail on pathogenetic mechanisms or investigative techniques.

Approximately half the chapters cover what may be loosely termed organ system pathology. The remaining chapters are more broadly based and cover multi-system topics, such as accidental and non-accidental trauma, metabolic disease, and miscellaneous conditions. In consequence, information on a given problem may be in either one section or the other, or even both.

Particularly useful are the chapters dealing with accidental and non-accidental injury. The latter covers aspects of child abuse and Munchhausen’s syndrome by proxy and will be of considerable help to pathologists faced with unusual patho- logical findings in a young infant or child in whom background circumstances may suggest unnatural causative mechanisms.

The chapters on metabolic and endocrine disease and ‘mis- cellaneous’ conditions cover a mixture of diseases, some of which, for example Marfan’s syndrome, may have been referred to in the systemic area of the book. Many of these diseases have by tradition been described in the ‘systemic’, ‘metabolic’ or ‘genetic’ areas of standard references, but are now understood to be disorders of genetic information. Authors at this time do have a problem in deciding in exactly which chapter a particular disease should now be described.

The last chapter is a useful discussion on the problems of SIDS, with comprehensive coverage of the aetiological and pathological features. The authors indicate the importance of a thorough and detailed death scene investigation and stress the importance of not using the term SIDS as a diagnostic dustbin until all possible avenues of investigation have been exhausted. The chapter ends with a comprehensive, if relatively brief, discourse on the possible causative mechanisms of SIDS.

Distributed throughout the book are a number of useful tables detailing a wide range of pathological entities affecting given organ systems, which can cause sudden death. These will form useful checklists for pathologists before embarking on individual autopsies. The book is written from an Australian perspective and the medico-legal framework described, par- ticularly in the appendices, is based on Australian jurisdiction.

In the appendices, protocols are detailed for the examination of SIDS. These are of particular interest. They were agreed by a group of pathologists involved in performing SIDS autopsies and would be useful models to inform databases, to allow for the analysis of complex epidemiological and pathological data in the investigation of SIDS. The protocols recommend X-ray, bacterial, viral, biochemical, and cytogenetic studies, inter alia. These recommendations and the proposition that up to 23 different tissue samples be reserved for histological examina- tion would no doubt raise the eyebrows of managers, some of whom may even be pathologists, as they strive to impose

234 BOOK REVIEWS

‘cost-effective’ (?cheap) protocols on those workers whose sole interest is to undertake quality investigation, with the families of patients in mind. Perhaps even more important may be the raising of the eyebrows of some pathologists performing autopsies on cases of sudden death in infancy and child- hood, who may also wrongly imagine that the recommended investigations are superfluous!

This book represents good value at E60.00 and will find a place on the reference shelves of paediatric, general, and forensic pathological laboratories.

M. D. O’HARA The Queen’s University of BeEfast

Major Problems in Pathology Volume 33. Pathology of the Thjwus and Mediastinunz M. J. KORNSTEIN and G. G. DE BLOIS. Published by W. B.

Saunders. No. of pages: 247. Price: E46. Most specialist textbooks are based on an organ system or

disease. The contents of this book, however, are determined by the boundaries of those spaces in the thorax included in the mediastinum. Thymic epithelial neoplasms and high-grade thymic B-cell lymphoma clearly fall within these spaces but other conditions, such as Hodgkin’s disease, present more commonly elsewhere in the body. This poses a problem for the author as to whether conditions such as Hodgkin’s disease should be dealt with in depth. The reader, faced with a possible case of Hodgkin’s disease, might question whether he or she would do better to turn to a textbook of haematopathology for guidance, rather than a textbook on the mediastinum. Patholo- gists serving thoracic surgical units will probably find this book of value. Its usefulness would, however, have been enhanced if

the authors had provided more detail on how to deal with and interpret biopsies obtained at mediastinoscopy which fre- quently suffer traction artefact, particularly if they are fibrotic. These problems may be compounded by emergency chemo- therapy or other treatments for obstructive symptoms that may precede the biopsy. The differentiation between nodular sclerosing Hodgkin’s disease, high-grade thymic B-cell lym- phoma, germ-cell neoplasms, and bronchial carcinoma may be extremely difficult in such cases, demanding a combination of interpretive skills, immunohistochemistry, and possibly molecular biology. The balance between a misdiagnosis and an unnecessary thoracotomy can be a fine one.

A test that I sometimes apply, when reviewing books, is to ask what help they would have provided with difficult cases that I have encountered over the years. A young woman with myasthenia gravis and mastocytosis of the thymus, not men- tioned, but it may have been a unique case. Extramedullary haematopoiesis forming a mediastinal mass in a patient with thalassaemia, not mentioned. Composite Hodgkin’s disease and high-grade thymic B-cell lymphoma, not mentioned. Despite failing this test, the text is generally well written, well referenced, and up-to-date. It provides a detailed account of the pathology of thymic epithelial tumours, mediastinal lym- phomas, mediastinal germ-cell tumours, and neuro-endocrine tumours, as well as a miscellany of other lesions that may arise or present in the mediastinum. The illustrations are of variable quality, although most are satisfactory. Despite its limitations, this book will find a useful role in our reporting room library.

D. H. WRIGHT Professor of Puthology

Southumpton University Hospita1.r Trust