Battle is a practical and sometimes lasting way of solving man's problems. It relies on the strength of the combatants and ignores the truth of the dispute. Discussion face to face can dissolve attitudes which have incorrectly determined judgements. The most striking example of this that I know is a Battle in Ireland in the eleventh century, where the king of Leinster fought a Viking prince. The Icelanders had raided Ireland for several generations in search of women, which they lacked since most of the population of Iceland were men who had arrived there by rowing long-boats from Norway. The prince was leading such a raid for the first time. Standing in the prow of the leading boat he saw Irish cavalry galloping along the beach to meet them. As they approached the shore the Irish king rode out of the band to challenge single combat. The Icelander jumped into the surf to meet him. As they raised their swords each realized that the other's face was like his own. When the Irish king spoke the other recognized the language. It had been spoken in Iceland by his grandmother who had been captured and taken there from Ireland. Swords were dropped and replaced by drinking horns. It was soon established that they were cousins. The battle gave way to a life-time of close co-operation.

Advances in breast cancer research, achieved through the progress of knowledge and development of new therapies, have been translated into improved quality of care for breast cancer patients. Clinical investigations and clinical trials have made the largest contribution to the body of knowledge that finds its way to the patient. Never before during the past decades of management of breast cancer has there been such a fruitful intellectual cross-fertilization of ideas among individuals involved in the generation of hypotheses, basic research, development of drugs and treatments, conduct of clinical trials, and statistical evaluation - the results of all of which are now translated into progress in clinical care. Even issues such as the quality of life of breast cancer patients, once the domain for few, are now being openly addressed by trials and discussed in a much broader forum. The IVth International Conference on the Adjuvant Therapy of Primary Breast Cancer, also known as the st. Gallen Conference, was again attended by more than 800 scientists and clinicians interested in this broad spectrum of breast cancer research and the interactions between such diverse fields of interest and specialties as cancer pathology, molecular biology, and psychosocial oncology. This volume collects findings and conclusions presented at the conference.

The third American edition has been completely revised and expanded, although parts of the text of the second edition have been included. I wish to acknowledge once again the excellent translation of the former two editions by Dr. ALAN B. ROTHBALLER and the late Dr. JERZY OLSZEWSKI. With this edition I have followed the general theme of the original German edition published in 1951. However, I have tried to consider modern techniques and the many new publications on the subject of brain tumors. Meanwhile, an early desire of mine has been fulfilled by the completion and publication of a classification which can be understood worldwide and hopefully be used widely, namely, the classi fication of the World Health Organization: Histological Typing of Tu mours of the Central Nervous System (1979). The classification which I used in the 1951 edition is very close to the final pattern of that accepted by the World Health Organization (WHO), since both follow the line of the BAILEY and CUSHING classifica tion of 1926/1930. To consolidate our old concepts and experiences we have reclassi fied our collection of 9000 cases with the assistance of my co-workers Dr. M. FUKUI, Dr. A. SATO. Dr. E. SCHARRER, Dr. E. SIMON, and Dr. J. SZYMAS. In the last decade two large atlases have been published, one called an Atlas of the Histology of Brain Tumors 1 (in six languages) and a second one called an Atlas of the Gross Neurosurgical Pathology 2."

Due to the topology and structure of the lymph nodes, their role in the pathogenesis and development of diseases is a very special one. Each organ and even each organ-related region of the body has its own group of lymph nodes, specific topological reactions, such as in circumscribed inflammation or in the metastatic spread of malignant tumors. On the other hand, all the lymph nodes of an organism join in a uniform function effected by highly differentiated structures. Volume 84 of Current Topics in Pathology presents our current knowledge about the structure and reaction patterns of this "sec ondary" lymphoid organ. Despite our original intention to publish all the contributions in one book, it became necessary to divide them: Part 1 focuses on the involved nodal compartments, cell types, and functions, while Part 2 describes their reactions in inflammatory, neo plastic, and immune-deficient diseases. Even with the cooperation of more than 30 authors, the coverage cannot be exhaustive. The scope of both parts is limited to those reactions that can be described by direct and indirect morphological methods, including modern tech niques such as immune electron microscopy."

possibly neoplastic, some not. In essence, the Often enough, in diagnosing cancer the last word rests with the pathologist and his or her micro book is concerned with interpretation of the scope. Often enough, too, the pathologist is borderline or histologically equivocal case and thought to dispense absolute truth: he does his the clinical implications thereof. It is based on best, but the truth he dispenses is not absolute. so me 390 examples of which most are individu Rather, with a greater or lesser degree of con ally described in brief. No useful purpose is fidence, he is making aprediction or expressing served by giving in detail the clinical and patho a prob ability of a certain kind of biological logical circumstances of every patient with, say, behaviour, and the degree of confidence with a dubious lesion of endometrium or larynx, or which he operates is based on experience. This with a similarly borderline papilloma in bladder experience is, in turn, based on the recollection or rectum, for each of these lesions exemplifies of earlier events, counsel from his mentors, from a familiar and 'standard' problem. Problems of his studies, and from discussions with colleagues. this kind will be examined as such but not the It would be going too far to agree with those details of every patient who posed them."

I was gratified by the most favorable reception and wide usage received by the first edition of this book. A decade seems to be a short period for a book on pathology, and yet it witnessed many important changes of concepts, along with a formidable growth of knowledge. The second edition required extensive reorganization. There are new chapters on mitochondriopathies, on peroxisomal diseases and on spongy myelino pathies. Major revisions and new additions were necessary in many chapters, for instance those on the dysplasias of the cerebral and of the cerebellar hemispheres, which were largely reorganized. The chapters on perinatal pathology were reordered and reorganized to give a more logical sequence of prenatal, perinatal and postnatal lesions. The entire text was worked over for brevity. A wealth of new references was added with the. aim of staying abreast with the literature up to summer 1988. All refer ences were double checked for errors. My gratitude goes to Mrs. Gisela Ropte and Mrs. Cynthia Bunker for their untiring, diligent help. As a result, this second edition is an essentially rewritten text. Advance in the prevention of human suffering is based on a thorough understand ing of the nature of disease. I hope that this text will continue to be of service in this behalf. Perhaps it may also reflect and foster the intellectual curiosity which makes the "reading of brains" so interesting an occupation. Gottingen, 1989 Reinhard L.

This two-volume treatise, the collected effort of more than 50 authors, represents the first comprehensive survey of the chemistry and biology of the set of molecules known as peptide growth factors. Although there have been many symposia on this topic, and numerous publications of reviews dealing with selected subsets of growth factors, the entired field has never been covered in a single treatise. It is essential to do this at the present time, as the number of journal articles on peptide growth factors now makes it almost im anyone person to stay informed on this subject by reading the possible for At the same time it is becoming increasingly apparent that primary literature. these substances are of universal importance in biology and medicine and that the original classification of these molecules, based on the laboratory setting of their discovery, as "growth factors," "lymphokines," "cytokines," or "colony-stimulating factors," was quite artifactual; they are in fact the basis of a common language for intercellular communication. As a set they affect es sentially every cell in the body, and in this regard they provide the basis to develop a unified science of cell biology, germane to all of biomedical research."

Laboratory Animal Medicine has made enor We deeply appreciate the efforts of each of the mous strides in the 47 years since R. Jaffe published authors and co-authors of the 23 chapters in this his "Anatomy and Pathology of Spontaneous Dis two volume work. In some instances the reader will eases of Small Laboratory Animals" in 1931. So note what appears to be repetition in certain chap ters. This repetition was allowed to stand in some much new information had accumulated that in a cases because different approaches seemed useful, new edition in 1958, Jaffe, aided by Cohrs and Meessen, needed the assistance of 46 colleagues to although efforts were made to delete most of the do the subject justice. Like its predecessor, this two redundancy which inevitably arises in a venture of volume comprehensive treatise on "Pathologie der this kind. We will be grateful if our colleagues point out errors and send us specific and general Laboratoriumstiere" was written in German and criticism of this work to allow corrections in the thus not readily available to the widening circle of event of reprinting or a next edition. veterinarians and pathologists who now are inter One objective has been to assemble current in ested in laboratory animals. Aside from the need to have a comprehensive formation in the pathologic aspects of diseases of review of laboratory animal pathology in English, laboratory animals."

J. Oort and J. P. A. Baak This manual is written by pathologists and is meant for pathologists. It deals with a subject that became especially popular in pathology at the end of the last decade: morphometry. Morphometry is defined as the quantitative description of a structure (Weibel, 1969). This structure may be both of macroscopic and micro- scopic size. Strictly, the size of an organ is a morphometric feature. This type of morphometry has long been in use in pathology. Examples ofthis type in diagnostic pathology have been given by Roesle and Roulet (1932). In this manual, however, the term morphometry is used in its re- stricted microscopic meaning, i.e., the quantitative description of micro- scopic images and features. The quantitative analysis of microscopic pic- tures has for a long time been subordinated to the qualitative description. This may partly have been caused by the preference of the human mirld for pattern recognition rather than quantitative appraisal, which leads to judgements based on impressions subconsciously tested against the ob- server's (mental) image of the normal pattern. Another cause may have been the time-consuming difficulties of collecting and computing quanti- tative information. During the past decades the usefulness of quantitative methods in histo- and cytopathology has been stressed for many different subjects. In addition, minicomputers have become widely available and are becoming increasingly inexpensive; the more so since the introduction of micro com- puters.

Human teratocarcinoma has long held a fascination to the pathologist be- cause of the diversity of the seemingly benign differentiated tissues asso- ciated with the tumor. An understanding of this diversity came with the demonstration of the pluripotent nature of the embryonal carcinoma cell, the stem cell of the tumor, in experimental animals. Single cell clones of murine embryonal carcinomas were derived and the resultant cell lines injected into immunosuppressed hosts, where the embryonal carcinoma stem cell itself gave rise to the wealth of differentiated tissues seen in teratocarcinomas. It was also shown that teratocarcinomas could be pro- duced experimentally by transplantation of staged early mouse embryo to extrauterine sites; subsequent experiments suggested that the embryonal carcinoma stem cell was, in fact, comparable to a normal cell of the em- bryonic ectoderm. Many elegant experiments have since been built on this early work; murine embryonal carcinoma cells are providing the ex- perimental material for a first biochemical evaluation of the earliest dif- ferentiation events in mammalian embryogenesis. In this volume, we relate the beginnings of experimental research on human teratoma. The human embryonal carcinoma cells have been char- acterized and established in vitro, providing an experimental model to study the unique biology of these cells. Monoclonal antibodies, estab- lished from work with these in vitro cultures, provide cell surface probes that define populations of embryonal cells and their derivatives in tumor sections.

In Videofluorscopic Studies of Speech in Patients with Cleft Palate, Drs. M.L. Skolnick and E.R. Cohn present multiview videofluoroscopy as a technique for the radiological evaluation of speech defects in patients with cleft palate. Dr. Skolnick's invaluable contributions as both the originator and leading authority on the subject are discussed in a concise, clinical fashion. Topics examined include the anatomy and imaging of the velopharyngeal portal; the equipment and techniques of multiview videofluoroscopy; the interpretation of results and various patterns of velopharyngeal closure; Passavant's Ridge and patterns of velopharyngeal closure; normal and abnormal speech production; and the evaluation of test results. This book is the only source which concisely and completely describes the technique and its interpretations for those who need a description of the clinical procedure.

The last few years have witnessed major developments in molecular biology which have had a significant impact on biomedical knowledge. As a result new concepts in cell biology have emerged, new etiologic agents have been discovered, and new drugs have become available. Furthermore, the world of mediators, cytokines, and humoral factors has enlarged considerably in a relatively short period and this has modified our views of diverse physio pathologic processes as well as opened up new therapeutic prospects. In addition, recent technologic advances have revolutionized our diagnostic methodology and have greatly enhanced the power of our therapeutic resources. All these factors have contributed to a substantial remodeling of both liver science and clinical hepatology, and these changes have generated the motivation for the production of the present book, which attempts to give an account of well-known clinical facts in the light of current thinking. It is the fruit of the coordinated work of experts from different countries in three continents. In a sense, it is a manifestation of the fact that inter national cooperation is becoming increasingly important not only in the expansion of science but also in its exposition. We hope that Hepatobiliary Diseases will be useful to both students and clinicians and that internists, gastroenterologists, and general practitioners will find in its contents a satifactory coverage of their field of interest."

We would like to take this opportunity of expressing our sincerest thanks to the many persons who have made adrenal tissue and related materials available to us for our work. Our especial gratitude is extended to Drs. J. J. Brown, A. Lever and J. I. S. Robertson of the M.R.C. Blood Pressure Unit, Glasgow, Dr. J. K. Grant, Royal Infirmary, Glasgow, Professor R. B. Welbourn and Dr. W. Kelly, Royal Postgraduate Medical School, Drs. D. B. Grant of Great Ormond Street, J. Ginsberg, Royal Free Hospital, D. C. Anderson, Hope Hospital, Salford, C. R. Edwards, St. Bartholomew's Hospital and Professor I. Doniach (for merly of the London Hospital) and Messrs. J.-c. Gazet, A. McKinna and P. Greening, Royal Marsden Hospital, London. The preparation and presentation of the material and the results would not have been possible without the help of Dr. P. Monaghan and his Electron Microscopy Unit, Ludwig Institute for Cancer Research (London Branch), Sutton, Mrs. Mitchell and her Histology Team, Royal Marsden Hospital, Sutton, Mr. K. Moreman of the Photographic Department of the Royal Marsden Hospital and Institute of Cancer Research, London and Mr. M. Hughes for graphics. Particular thanks are due for the untiring efforts and assistance ofMr. J. Ellis and Mrs. D. Corney of the Ludwig Institute for Cancer Research (London Branch), Sutton, for most of the photographic and secretarial work respectively. Professors G. Dhom and E. Mausle kindly provided material for Figs."

In commissioning this volume of Current Topics in Pathology, the editor of the series, Prof. Sir Colin Berry, asked me to produce something "which is aimed at the general pathologist but from the point of view of the neuropathologist who knows what is not being done well." This was easier said than done. Many aspects of neuropathology are encountered only infrequently in general pathology and are best dealt with by re ferral of material to a specialist unit. Others need more extensive investigation than is practicable in a general pathology setting. Yet neurological disorders in general are common and are encountered by general histopathologists, paediatric and forensic pathologists on a daily basis, particularly in autopsy practice. In inviting contributions to this volume of Current Topics in Pathology, I therefore biased the con tents towards disorders in which the conduct of the autopsy and the initial approach to neuropathological investigation are of critical importance in making the diagnosis. The authors all have a wealth of experience and expertise and I believe that this is reflected in their approach, which is both personal and practical. Indeed, the emphasis in this book is very much on the provision of practical advice. All of the chapters contain guidelines on the conduct of autopsies as well as infor mation on the macroscopic and basic histological assessment of the nervous system in the relevant disorders."

The translation of Blood Smears Reinterpreted was begun when the French original was still undergoing revisions. I was accorded the oppor tunity to question any statement or turn of phrase that was unclear to me or appeared liable to misinterpretation. It is my hope that as a result, ambiguities-particularly those inherent in differences between American and Eu ropean usage-have been removed and that I have at least ap proached the ultimate goal of any translation: to reflect the author's intention accurately while remaining as readable as the original. Beyond the role of translator, I was encouraged to assume the role of critic. As a result, some pages or even single sentences were hotly debated, sometimes for hours, as Marcel Bessis insisted that any inter pretations on which we could not agree should be so indicated. In fact our discussion invariably ended in agreement, though they led to changes of a sentence here or a word there and, on occasion, to the addition of a footnote or a brief paragraph.

New techniques make it possible for investigators to examine and sometimes quantify various aspects of nuclear morphology and function; now they can derive clinically and biologically useful information about the nucleus. This book draws together a series of techniques which have been successfully applied to the study of the nucleus of tumour cells. These are of fundamental importance to researchers in tumour histopathology and medical oncology. Detailed reviews are given of various aspects of the morphology, ploidy and karyotypic status and function of the nuclei in the cells of tumours and preneoplastic lesions. Topics covered include nuclear morphology in tumour diagnosis, the ultrastructure of the nucleus, karyotypic analyses of solid tumours, flow cytometric assessment of nuclear ploidy and other parameters, histomorphometry of the nucleus, and in situ hybridisation.

Sarcomas represent a group of rare tumors which arise from the largest tissue compartment of the body, but account only for about 1 % of all malignancies. Among this group of tumors, soft tissue sarcomas in adults are, in addition to osteosarcomas, the most important. In the diagnostic workup of soft tissue sarcomas modern radiological investigation methods such as CT and MRI techniques are being critically evaluated. While it is widely accepted that the conventional, stained microscopic specimen is still the cornerstone for properly planned treatment stra tegies, immunohistochemistry has come to play an indis pensable role in accurate classification. Reviewing the surgical techniques, the treatment of musculo-skeletal malignancies, especially of soft tissue sarcomas, has changed considerably over the past decades. While amputation used to be the surgical treatment of choice limb-saving procedures have now become an im portant therapeutic modality in treating such lesions, particularly in combination with percutaneous or interstitial radiotherapy. Despite adequate local treatment, many patients with soft tissue sarcomas will ultimately develop metastatic disease, usually in the lungs. For this reason, effective ad juvant systemic treatment should be given simultaneously with or soon after treatment of local disease. The results of several randomized trials evaluating adjuvant chemotherapy have been reported in the meanwhile, indicating im proved, disease-free survival with a trend towards improved overall survival. In disseminated disease, drug combi- VI Preface nations or single agents are used as palliative treatment and might help to improve survival in selected subgroups."

Pathology in general is closely linked with clinical medi- cardiographic changes may be desired and therefore a cine and in cardiovascular pathology this interdepend- short section has been included on cutting the heart ence is, perhaps, greater than in most other specialities. according to conventionally used echocardiographic In recent years great advances in investigatory proce- planes. dures have taken place, including the examination of The heart can only react to physiological changes or fresh endomyocardial tissue obtained by bioptome, per- damage in a limited way and therefore a separate chapter mitting not only clinico-pathological correlation but also on hypertrophy and dilatation and another chapter deal- examination at histochemical and ultrastructural levels. ing with changes in the endocardium, which reflect hae- Angiography has gained wider usage and two-dimen- modynamic alteration and may additionally show sional echocardiography is no longer the preserve of diagnostic features, are also included. Degeneration to- specialized units. Percutaneous coronary transluminal gether with changes in connective tissue and ischaemic angioplasty is a relatively new approach to relieving heart disease are separately presented. Atherogenesis, obstructive coronary artery disease. Cardiac pathology recognition of myocardial infarction and the earliest mor- has therefore moved apace, providing not only a back- phological changes discernible at histochemical and ground to clinical manifestations but also visual proof for ultrastructural levels of investigation, which are within other investigations such as immunology and virology. the scope of modern routine laboratories, are empha- Such investigations have played an essential role in sized.

Soft tissue tumors are a very heterogeneous group of tumors in terms of histogenesis, morphology, cytogenetics, molecular biology, clinical manifestation, and prognosis. Their spectrum is fascinating for morphologists and basic scientists alike. Yet precisely this variability in the morphologic manifestation of soft tissue tumors, specifically their histologic and cytologic patterns, presents great difficulties to any effort to categorize them. Although many soft tissue tumors are today defined not only by histology but also by immunohistochemical, cytogenetic, and molecular biological findings, the histogenesis of many soft tissue tumors, in particular malignant ones, continues to be unknown. This is associated with the fact that the actual precursor cells that lead to these tumors have frequently not yet been identified. For this reason, the customary classification of malignant soft tissue tumors is primarily not histogenetic, but actually according to the dominant phenotype, however characteristic it is. Of course, an exact morphologic examination of soft tissue tumors con tinues to be an essential prerequisite for making a diagnosis and determining a therapy. The use of a wide range of additional modern examination techniques, however, can make a substantial contribution toward more precisely defining the biological behavior of a tumor, which without doubt can have therapeutic implications.

The preceding decade has seen the production of many cancer at lases. As with other techniques of descriptive epidemiology, these atlases have proved valuable in identifying areas for further re sear~h employing the methods of analytical epidemiology. How ever, the various cancer atlases produceq to date have failed to pro vide a common format of presentation, which has limited their comparability and frustrated in a large measure any attempt to compare risks across national boundaries, boundaries which in terms of environmental exposures may have little meaning. In this volume, many features of cancer atlases are presented and there are discussions on the areas where moves towards standardization could greatly increase the utility of the finished product. In contrast to topographic maps, i. e., representations of natural and man-made features on the surface of the earth, thematic maps concentrate on displaying the geographical occurrence and varia tion of a single phenomenon - the "theme" of the map. The link between thematic and base mapping is rather strong as the themat ic information to be depicted is of greater value if displayed on an accurate base map. Further, the thematic map generally uses statis tical data which are frequently related to internal administrative boundaries for enumeration. The major reason for constructing a thematic map is to discover the spatial structure of the theme of the map and to then relate the structure to some aspects of the under lying environment.

General pathologists see many biopsies from transplanted organs but few are in large enough centres so that this forms the bulk of their work. The book describes the changes which can be observed in transplantation in all of the major organ systems that are routinely transplanted and there are accounts of the pathology of infections and of the immunological difficulties that are faced by these patients. The volume will be a valuable guide for those who wish to braoden their knowledge in this field.

This book has been written from two points of view: firstly, from the viewpoint of those who are involved in the diagnosis and treatment of lymphoid malignancies, who must meet the challenge of integrating the new biological insights into their knowledge of these diseases; and secondly, from the viewpoint of those who are involved in basic biological approaches to malignancy and immunology, who wish to know more about the function of the lymphoid tissues and their malignant diseases. Neoplasia of lymphocytes is a focus for considering many of the most important biological advances impinging on cancer in the past two or three decades, because malignant lymphoproliferative diseases offer unequalled opportunities for studying many aspects of cancer. We probably know more about lymphocytes than other normal cells because of the ease with which they can be obtained. For the same reason we probably know more about malignant lymphocytes. One or other aspect of most of the momentous advances in biology of the past two or three decades has implications for lymphoid malignancies: hybridoma technology and the use of monoclonal antibodies, gene technology, the understanding of oncogenes and growth factors in the control of growth and differentiation, insights into causation of cancer by potent tumour promoters such as the phorbol esters and by viruses, and knowledge of the control of growth function of lymphocytes themselves. Conversely, many of the advances in understanding lym phocytic leukaemias and lymphomas have implications for other cancers."

Marburg and Ebola virus, the two species within the family Filoviridae, are among the most pathogenic agents causing fulminant hemorrhagic fever in humans and nonhuman primates. The chronology of filovirus epidemics and epizootics proves that these viruses are prototypes of emerging/re-emerging pathogens. Since the discovery of Marburg virus in 1967 until the recent Ebola virus outbreaks in Central and West Africa filoviruses have not only raised the interest of scientists, but have also been a matter of high public concern. With the advent of recombinant DNA technology our knowledge on the genome structure and the replication strategies of these agents has significantly increased. This volumes gives an overview on many aspects of filovirus research and summarizes recent advances in the field. The topics addressed include the molecular biology of filoviruses, pathogenesis, epidemiology, immune response, as well as clinical aspects and diagnostic measures.

Significant progress has doubtlessly been made in the field of cere bral protection compared to earlier centuries, as recently reviewed by Elisabeth Frost (6). She cites the recommendations for treat ment of brain trauma by Areteus, a Greek physician of the second century A. D. He expressed quite modem views with regard to the need for prompt action considering complications that follow even minor symptoms. He advised burr holes for evacuation of hema toma in seizures, the use of diuretics and, most interestingly, also hypothermia. German surgeons of the 17th century had little more to offer than prescriptions of which the most effective constituent was alcohol (10). Thus, Sir Astley Cooper was probably the next surgeon to make noteworthy contributions when advising the use of leeches to the temporal artery and other means of bleeding in stead of surgical intervention in cases of raised intracranial pressure (loc. cit. 6). Although our knowledge has greatly expanded during the last two decades, extensive discussions have led to only few conclusions. Promising results from animal studies were translated to clinical sit uations only to yield controversial and sometimes confusing results. Since the observations of Brierly (5) on ischemic cell damage, im proved information on structural aspects, probably even related to concomitant biochemical studies, should allow the validity of thera peutic concepts to be verified. Investigations on cerebral ischemia have led to the differentiation of synaptic transmission failure and membrane failure."

There have been many advances in the field of gastrointestinal pa thology which are of considerable clinical significance during the 13 years since the last publication of a volume of Current Topics in Pathology devoted to this subject. Many have arisen from the app lication of new techniques of histochemistry, immunocytochemi stry, quantitative morphometry and molecular and cell biology to gastrointestinal diseases, but some, notably the recognition of the association of Campylobaeter pylori with the commonest type of chronic gastritis, have been achieved using such long established 'routine' histological procedures that one wonders how their signifi cance had escaped recognition for so long. The topics covered in this volume have been selected because they present advances of relevance to the diagnostic clinical pathologist. However, they re present the personal selection of the editor, and are in no way exhaustive. Many other examples of progress in our understanding of the pathophysiology of gastrointestinal diseases have been omit ted, either because of the confines of space or because they have been well reviewed recently in other publications. Most of the workload of the practising gastrointestinal patholo gist involves the diagnosis and assessment either of inflammation or of neoplasia in the alimentary tract, and this is reflected in the topics presented in this book."