Pathology of Bone Marrow and Blood Cells

With the second edition of Pathology of Bone Marrow and Blood Cells, Farhi has produced a concise and agreeably illustrated overview of hematopathology as it relates to the bone marrow and peripheral blood and has succeeded in her goal “to make the text clear and accessible rather than encyclopedic.” As such, the text is an excellent introduction to hematopathology for medical students and residents and a useful reference guide for most clinicians. Experienced pathologists and hematopathologists are less likely to use this reference frequently in daily practice.

The text is a manageable size, with 309 pages not including the appendices and index. The images are in full color, of adequate size, and are well chosen to represent the entities described. A fine example is the impressive series of photomicrographs and the superb accompanying text on reactive morphologic changes seen in hematopoietic cells. Purchasers of the text also receive online access to the fully searchable full text and figures as well as to an image bank allowing.jpg or.pdf downloads of the figures. The search function is particularly welcome, because the reader can enter a search term instead of using the printed index and immediately be directed to the relevant text and figures.

The references are abundant and appropriate, allowing the reader to find relevant, more in-depth information in the literature. Unfortunately, the organization of the 99-page appendix containing the references is somewhat ungainly: each chapter has an independently numbered set of references, and it is difficult to locate the correct reference quickly, because the corresponding chapter numbers are not listed on every page in the appendix.

The authors made every attempt to include the pertinent changes in the most recent (2008) edition of the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues.¹ As stated in the preface, the diagnostic criteria from the 2008 World Health Organization (WHO) text were not available at the time of printing; however, the list of diagnostic categories is included as an appendix and is referred to in the text. This leads to awkwardness in some places. For example, the section on myelodysplastic syndromes discusses both the 2001 and the 2008 classification systems, presenting diagnostic criteria from the 2001 system and including an in-text note encouraging readers to consult the 2008 WHO text for current criteria. However, not all terminology used to describe hematopoietic neoplasms has been updated. For example, despite the appearance of the current term “blastic plasmacytoid dendritic cell neoplasm” in the summary of the 2008 WHO classification in the appendix, this tumor is still referred to by its previous designation, “CD4⁺/CD56⁺ hematodermic neoplasm,” in the text.

The discussions of the various disease entities are clear and informative. They provide a brief but not overwhelming summary of relevant clinical features, as well as illustrated and concise description of morphologic features, a summary of pertinent phenotypic and molecular features, and a list of differential diagnoses. A particularly nice example is the section on acute myeloid leukemia, which clearly summarizes the morphologic, phenotypic, and genetic subtypes of this disorder, with beautiful accompanying images of morphology and cytochemical staining patterns. It would have been worthwhile to also include illustrations of immunophenotypic and molecular features, because interpretation of these features is critical for the diagnosis of many hematologic diseases. Occasionally, this information is provided in tabular format, as in the tables on mature small B-cell and plasma cell neoplasms. Most tables, however, are simply 1-dimensional lists of entities or differential diagnoses and do not provide distinguishing features of the listed entities.

In summary, this book is a concise and well-written overview of blood and bone marrow pathology. Trainees will appreciate the clarity of the text and the superb illustrations, while most practicing pathologists and hematopathologists will find themselves requiring another source for help with challenging diagnoses or for in-depth descriptions of pathophysiological processes.