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Atlas of tumor pathology, tumors of the esophagus and stomach

1999; Elsevier BV; Volume: 117; Issue: 2 Linguagem: Inglês

10.1053/gast.1999.0029900508

1528-0012

Timothy D. Jenkins,

Lung Cancer Treatments and Mutations

By Klaus J. Lewin, M.D., F.R.C.Path, and Henry D. Appelman, M.D. $65.00. American Registry of Pathology, Washington, D.C., 1999. ISBN 1-881041-39-5. The highly regarded series of pathology atlases from the Armed Forces Institute of Pathology (AFIP) is now available in CD-ROM format. This medium is particularly well suited for a pathology atlas because it allows the user to access and display images and related text rapidly. The electronic “fascicle” reviewed, Atlas of Tumor Pathology, Tumors of the Esophagus and Stomach, is one volume in the AFIP atlas series. The CD-ROM package contains an instruction manual for installation and use of the software; all medical information is contained on the disk. Installation is simple, driven by a few typed commands in the PC format or icons in the Macintosh format. The CD-ROM was installed on both a Windows 98 PC system (450-mHz Pentium II processor, 128-megabytes RAM, DVD-ROM drive) and a Power Macintosh G3 unit; both installations took less than 1 minute to complete. Retrieval and display of tables, figures, and images from the CD-ROM was almost instantaneous on both of the systems tested. The minimum system configuration described in the instructions is a 80386 processor, Windows 3.1×, 4 megabyte RAM, and 1-megabyte free hard-disk space along with a monitor supporting 256 colors at 640 × 480 resolution. Probably the most important component of the computer system for optimal use of this CD-ROM is the video capacity: monitor resolution and viewable space. A technical support toll-free phone number is included with the CD-ROM, which allows the user to speak with a technical assistant or leave a recorded message regarding any questions. The atlas is organized into 15 chapters and provides extensive descriptions of gastric and esophageal neoplasms. It also covers topics such as handling of biopsy specimens and normal anatomy and embryology. Gastric endocrine cell neoplasms are covered in excellent detail. In the chapter on gastric adenocarcinoma, the pathological description and many illustrations follow a discussion of the prevalence, incidence, pathogenesis, genetics, and predisposing conditions. Preinvasive lesions and dysplasia are also discussed and well illustrated. The electronic fascicle reads like a book. Figures appear in one window, and accompanying text appears in an adjacent window. Reference numbers are conveniently included as “hypertext”: the detail of a reference in the chapter can be viewed separately without turning to the end of the chapter. The quality of the figures and tables is excellent. Figures include gross and microscopic specimens that illustrate both typical and atypical features of the tumors. The figures can be examined as small thumbnail sketches, half-page images alongside the text, or full-screen magnified images. Resolution and detail remain excellent with the full-screen images. This atlas is exceptionally thorough, as to be expected for a work written by pathologists primarily as a reference text for pathologists. The atlas readily reaches this intended audience. As a gastroenterologist, I found the CD-ROM to be well organized, clearly presented, extensively referenced, and easy to use. Indeed, the detail combined with the format of presentation and search features are ideal for clinical specialists who may encounter unfamiliar pathological diagnoses in the course of treating patients with neoplasms of the esophagus and stomach. In the section on esophageal squamous cell carcinoma, for example, many histological images of different degrees and patterns of dysplasia are provided. Surgeons of the upper gastrointestinal tract should find the information useful, as will oncologists. Criticisms with this work are minor. The PC installation method needs to be updated, because most CD-ROM installations are driven by a series of prompting questions rather than by typed instructions. With regard to content, there do not appear to be critical omissions. Some of the background information on the molecular genetics of the tumors is not completely up-to-date, although molecular genetics is not the principal focus of the atlas. With regard to the pathology, all aspects of tumors of the esophagus and stomach are illustrated in excellent detail. From a clinician's point of view, more emphasis could be placed on the rapidly emerging entity of adenocarcinoma of the esophagogastric junction. Having taken advantage of the CD-ROM format, AFIP might consider an online edition of the atlas series. While the print version is portable, albeit less compact, the CD-ROM is, in a way, less portable (at least for those without portable PCs). A “subscription” to an electronic atlas, accessible over the Internet, would extend portability so that the atlas would no longer be tied to an individual PC. Users with a subscription could access the data wherever they have access to a PC, on a hospital floor, in the library, at home, or at a conference. Bottom Line: This CD-ROM is an outstanding reference in convenient electronic form for specialists who care for patients with tumors of the esophagus and stomach. The fascicle will be of use not only to the gastrointestinal and general pathologist but also to surgeons, gastroenterologists, and oncologists.