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."

Practicing specialists in pathology, laboratory medicine, and obstetrics comprehensively summarize the latest scientific findings and their experiences in the use and interpretation of laboratory testing in patients who are pregnant or experiencing recurrent pregnancy loss. Topics of interest include the effects of normal physiological changes on test results, test selection for diagnosis, changes in reference ranges, monitoring the pregnant patient, new technologies, and the limitations of laboratory testing. The authors not only clearly explain currently used test methods and technologies for the nontechnical reader, but also provide comprehensive details for laboratory professionals. The comprehensive appendix that compiles published normal reference ranges by first, second, and third trimester consttitutes an excellent resource for professionals caring for pregnant women.

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."

Various textbooks on stereotactic neurosurgery have been published during the last few years (Riechert 1980, Schaltenbrand and Walker 1982, Spiegel 1982), all of them dealing with functional stereo tactics as the major subject in the field. Diagnostic and therapeutic stereotactic interventions are only briefly described, whereas localization techniques are not yet mentioned. Since 1980, however, an increasing number of reports has been published on CT guided and computer monitored stereotactic performances which enable the surgeon to combine diagnostic and therapeutic efforts in one session. With recent progress in scanning techniques, including high resolution CT, NMR, and PET imaging of the brain, it has become possible to study and localize any brain area of interest. With the concomitant advances in computer technology, 3-dimensional reconstruction of deep seated lesions in stereotactic space is possible and the way is open for combined surgery with stereotactic precision and computer guided open resection. This type of open surgery in stereotactic space is already being developed in some centers with the aid of microsurgical, fiberoptic, and laser beam instrumentation. With these advances stereotactic techniques will rapidly become in tegrated into clinical neurosurgery. Stereotactics has become a metho dology which enables the surgeon to attack deep seated and subcortical small tumors. Neurosurgeons may abandon therapeutic nihilism, still frequently seen in glioma treatment, in the near future when stereotactic resection will be feasible and remaining tumor cells may be killed by adjuvant treatment modalities still in development."

Hyperthermia as a safe and effective cancer treatment modality is rapidly evolving propelled by widespread research and clinical efforts worldwide. Presentations on Hyperthermia experience are now commonplace at Oncology meetings, as are congresses dedicated entirely to the intertwined interactions between basic sciences and patient treatment that together are forming the structure of a new medical specialty. Such was the XII International Symposium on Clinical Hyperthermia held in Rome, Italy, April 27 - 29, 1989. Papers presented therein constitute the backbone of this book. Biology research has provided data describing mechanisms of action for the cancer cell killing and physiological effects of Hyperthermia. Physics research has led to the development of equipment enabling treatment of many areas of the human body, as well as explained the limitations that still constrain our ability to treat, especially in the areas of deep seated tumor heating and non-invasive thermometry. The main question that will decide the future of this modality is that of its clinical use. To put it succinctly, what do we do with this potentially useful tool in an everyday clinical oncological practice . ** ? This is the main question addressed in this book as "Consensus on Hyperthermia for the 1990s. " The book in cludes 28 presented papers and 25 invited chapters from some of the leading experts in the field. Their basic mechanisms of action were physics principles, treatment quality assurance and especially, clinical indications.

INHALT: The Concept of the BBB: an Historical Perspective Anatomy of the BBB Pathophysiology of BBB * Brain oedema Breakdown of the BBB BBB Dysfunction after SAH * Clinical Monitoring Neuroradiological Evaluations of BBB Dysfunction after SAH * Computerised Tomography and Magnetic Resonance * SPECT and PET Experimental Data * Literature Review of BBB Dysfunction after Experimental SAH * Qualitative Assessments * Quantitative Assessments * Time Course of BBB Dysfunction after SAH * Additional Pathophysiological Changes after SAH - Cerebral Vasospasm - CSF Eicosanoids - Cerebral Metabolism - Behavioural and Neurological Deficits - Intracranial Pressure - Blood Pressure, Blood Gases, Plasma pH, Plasma Glucose, Body Temperature Strategies for Pharmacological Interventions * Hydroxyl Radical Scavenger AVS * Glutamate Antagonist Felbamate * Calpain Inhibitor II Challenges and Future Directions * Advances in Cerebrovascular Pathophysiology Elucidation * Gene Therapy

It has only recently been appreciated that the immune and skeletal systems have major interactions. It is now well documented that osteoclasts, which are important cellular mediators of skeletal homeostasis, are derived from hematopoietic precursors that also give rise to immune cells. In addition, numerous cytokines that were first shown to regulate immune cell function have also been demonstrated to regulate bone cells and influence skeletal health. Conversely, products of bone cells appear critical for the engraftment of marrow in bone, the normal development of the hematopoietic and immune systems and provide niche for long-term memory B and T cells.

In the past scientists involved in immune and bone cell investigations have rarely interacted in a significant way as these disciplines have developed independently and, for the most part, remain separate. The conference will bring together leading international scientists from both fields to interact so that new collaboration can develop and more rapid progress in understanding the relationships between these fields can be achieved. Short talks will be selected from abstracts from the international community. This conference will have a format to provide an environment of maximum interaction and interchange through lectures, posters, and open discussion.

This book represents the culmination of the major aspect of Dr. Margot Shiner's professional career. It was she who devised the technique of jejunal biopsy which opened up whole new fields of small intestinal research, including microbiology, immunology, histochemistry and histopathology, thus greatly expanding our knowledge of fundamental aspects of absorptive patho physiology. Later the application of electron microscopy demonstrated the individual cell with its mechanisms both for absorption and for the production of so many chemicals such as mucus, enzymes and hormones. Like the vision from the peak in Darian, it opened up new worlds. The contribution to our understanding of cell structure and function has been greater than the direct elucidation of specific diseases but nevertheless, there are pointers to different mechanisms which could have wide applications. It is a book which serves a double function: On the one hand it is highly technical and a publication for the super expert, recording new landmarks of knowledge and interpretation. On the other hand, it is a book which can indeed fire the imagination of the rising generation of gastroenterologists, paediatricians, pathologists and medical scientists. Having seen the emergence of the art and science of present-day gastro enterology within my professional lifetime and having been able to provide the facilities for her work in the very early days, it is with particular pleasure and pride that I write this foreword."

Fresh research has opened up new vistas in forensic pathology that are allowing for closer national and international cooperation between pathologists and scientists in a range of medical and scientific disciplines. At the same time, autopsy and laboratory techniques are undergoing rapid evolution, with new procedures coming on stream while existing processes yield additional -- and more accurate -- results. This sixth volume of reviews in forensic pathology provides professionals working in the field with cutting-edge material on the latest key advances in the fields of traumatic death, sudden natural death and death time estimation. Now with numerous color illustrations, the book gives forensic experts across the world a fully up-to-date guide to contemporary procedures and theory in forensic science and medicine. The chapters cover an exhaustive range of aspects in the discipline, from the analysis of sudden natural deaths in infancy and childhood to the cardiac proteomics approach in the study of cases involving sudden cardiac death. Other specialist chapters deal with the forensic investigation of deaths in aviation and as a result of accidents involving all- terrain vehicles. The volume covers fresh research in the use of protein markers for the estimation of post-mortem intervals, and features a chapter telling the story of the medico-legal investigation into the deaths resulting from the 9-11 terrorist attacks on the World Trade Center.Comprehensive and current, this fresh volume of reviews is an essential resource for professionals who need to stay ahead of the game in a fast-moving and exciting field of scientific endeavor.

This is an invaluable collection of information designed to help residents, fellows, and students - as well as any already qualified medical professional interested in revising the essentials of skin conditions - to master the basics of skin pathology. Using the principle of pattern recognition, it simplifies the multitude of dermatopathologic signs by using easy-to-memorize images of what the key features look like - photomnemonics. There are also helpful sections on the technical aspects of dermatopathology and on the key findings at each level of the skin. Organized simply and abundantly illustrated, this text will be an indispensable guide to revision for all its readers.

The European Study Group for Cell Proliferation held its XVth Meet ing at Sundvolden, Norway, in September 1987. The program included a symposium on the cell kinetics of the in flammatory reaction, with invited speakers. This volume of Current Topics in Pathology contains the manuscripts submitted by the speak ers. Inflammation is a very broad area, and the cell kinetics of the inflammatory reaction comprises a large number of topics. A full cover age would fill more than one book. This volume therefore contains only a few of the important aspects of the cell kinetics of the inflammatory reaction. It is hoped that it will serve as inspiration for further research in this important area. Inflammatory diseases are even more important than cancer, and there is a great need for a more detailed information about inflammation. OLAV HILMAR IVERSEN Contents Chapter I The Cell Kinetics of the Inflammatory Reaction. Introduction and Overview."

The Nato Advanced Study Institute on Humoral Immunity in Neurological Diseases became possible thanks to the active help of many people. I will not mention our colleagues at the neuroche- mical laboratory of the Born-Bunge Foundation : it was our common job. But I wish to thank : - the Nato and Dr. Kester for their aid, support and gene- rosity, - the Belgian Ministry of Foreign Affairs and Secretary-ge- neral Mr. Grandry for their help and assistance in esta- blishing valuable contacts with many foreign countries, - the Belgian Ministry of Culture for their grant, - the National Fund for Scientific Research and the Belgian Society of Neurology for their financial support. Substantial help came from the Universitaire Instelling Ant- werpen : not only financiall~ but by allowing members of their staff to assist us 'in many ways. The Belgian Friends of the Weizmann Institute and the Belgian Medical Care for Israel helped invite some participants, and many firms made a contribution to our organization. To all of them our warmest thanks.

When presented with the task of editing a volume on such a wide When presented with the task of editing a volume on such a wide and and diverse diverse topic topic as as Ovarian Ovarian Pathology, Pathology, it it is is difficult difficult to to know know how how to to limit limit the the range range of of subjects subjects to to be be covered covered when when there there are are so so many many taxonomical taxonomical entities, entities, both both neoplastic neoplastic and and reactive reactive that that could could be be included. included. However, However, I I have have chosen chosen to to cover cover concepts concepts that that are are not not usually usually dealt dealt with with in in depth depth in in Gynaecological Gynaecological Pathology Pathology textbooks. textbooks. From From the the clinicopathological clinicopathological viewpoint, viewpoint, a a wealth wealth of of new new data data has has been been updated updated and and critically critically reappraised. reappraised.

Progress in science is often promoted by a new method. Diagnostic cytology, however, developed slowly over a whole century, mainly in differentiating malignant from benign cells from various tissues. The decisive step in this development was the intensive investigation of one local ization by Papanicolaou: The application of cytology for screening in the field of gynecologic oncology made it an acknowledged technique. Consequently, materials inves tigated before were tested again on a larger scale and new ones were included into the program. The possibility of a wide-range application of this diag nostic method, which carries a low risk for the patient and is low in cost, attracted the specialists of many fields. One of the problems which has resulted is the coordination of training and quality assurance for a large group of people from different fields and with different interests and whose experience in morphology varies. In this volume general problems of cytology are dis cussed, as is the question "who is a medical cytologist?" Education and training are the topics of the contributions by Coleman, Holzner, Jenny, Koss and Muller, cover ing the situation in the European Community, Germany, Austria, Switzerland, and the USA. A special contribu tion by Lange concerns the situation of cytotechnologists, paramedicals important for cytologic screening programs.

Information analysis centers were developed to help the scientist and practitioner cope with the ever increasing mass of published and unpublished information in a specific field. Their establishment resulted from a further extension of those pressures that had brought about the formation of the specialized primary journal and the abstracting services at the turn of the century. The information analysis center concept was greatly advanced by the 1963 report of the President's Science Advisory Committee Panel on Science Information. This report stated: " . . . scientific interpreters who can collect relevant data, review a field, and distill information in a manner that goes to the heart of a technical situation are more help to the overburdened specialist than is a mere pile of relevant docu ments. " Such specialized information centers are operated in closest possible contact with working scientists in the field. These centers not only furnish information about ongoing research and dis seminate and retrieve information but also create new information and develop new methods of infor mation analysis, synthesis, and dissemination. The continually expanding biomedical literature produced by scientists from the world's laboratories, research centers, and medical centers led the National Institute of Neurological Diseases and Stroke in 1964 to initiate a National Neurological Information Network of specialized centers for neurological information. The Centers are designed to bring under control and to promote ready access to important segments of the literature."

Changing approaches to diagnosis and clinical management of the uterus are comprehensively examined in this book. It gives a concise update of new concepts in physiology and pathology and their application in clinical practice. The book is designed especially for the gynecologist actively involved in patient care. Topics discussed include the pathophysiology of diethylstilbestrol (DES) changes, the immunology of the uterus, papillomaviruses and cervical neoplasia, endocervical carcinoma, mesenchymal tumors and diagnostic procedures such as colposcopy of the cervix, hysterosalpingography, and magnetic resonance imaging. The status of contemporary management is presented for hysteroscopy and hysteroscopic surgery, the congenital absence of the uterus and vagina, anovulatory dysfunctional uterine bleeding of the adolescent, uterine leiomyomata, genital prolapse, endometrial adenocarcinoma and childhood rhabdomyosarcoma of the vagina and uterus.

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 entire 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 impossible for anyone person to stay informed on this subject by reading the primary literature. At the same time it is becoming increasingly apparent that 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 com mon language for intercellular communication. As a set they affect essentially 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. This treatise is divided into four main sections. After three introductory chapters, its principal focus is the detailed description of each of the major peptide growth factors in 26 individual chapters."

Information analysis centers were developed to help the scientist and practitioner cope with the ever increasing mass of published and unpublished information in a specific field. Their establishment resulted from a further extension of those pressures that had brought about the formation of the specialized primary journal and the abstracting services at the turn of the century. The information analysis center concept was greatly advanced by the 1963 report of the President's Science Advisory Committee Panel on Science Information. This report stated: " . . . scientific interpreters who can collect relevant data, review a field, and distill information in a manner that goes to the heart of a technical situation are more help to the overburdened specialist than is a mere pile of relevant docu ments. " Such specialized information centers are operated in closest possible contact with working scientists in the field. These centers not only furnish information about ongoing research and dis seminate and retrieve information but also create new information and develop new methods of infor mation analysis, synthesis, and dissemination. The continually expanding biomedical literature produced by scientists from the world's laboratories, research centers, and medical centers led the National Institute of Neurological Diseases and Stroke in 1964 to initiate a national Neurological Information Network of specialized centers for neurological information. The Centers are designed to bring under control and to promote ready access to important segments of the literature."

During the past three decades, histology has seen enormous progress, thanks to new techniques and new investigation instruments. Numerous discoveries of important structures and morphofunctional phenomena have been described in a wealth of papers of ever increasing size and complexity. These publi cations have become difficult to follow, not only because of their number, but also because of a disparity of terminology and the multitude of synonyms employed by different authors. All of this makes reading and comprehension of the progress that has been achieved laborious, even for histologists, but especially for students, researchers in other basic branches of medicine, or clinicians who have to consult histological texts during their studies or investigations. In order to facilitate the orientation of all those interested in histology, a concise and practical volume in encyclopedic style, defining and, at the same time, illustrating fundamental histolog ical terms, enumerating synonyms, and describing morpho functional phenomena has become necessary, both because a work of this genre does not exist and because the list of Latin terms elaborated by the International Anatomical Nomenclature Committee in 1977 does not give illustrations or definitions of histological terms. The present work attempts to redress this deficiency."

In this book, precursors of gastric cancer are described histopathologically, especially about the precancerous conditons and precancerous lesions of the stomach. In addition to those precancerous changes stated in previous monographs and textbooks, some newly recognized gastric dysplasias are proposed. In order to be able to ovjectively evaluate the atypism of dysplasic changes, achievements of morphometric studies were presented.

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.

This book is a unique surgical pathology grossing atlas, comprised of a collection of photos of various anatomic specimens frequently encountered in routine and frozen surgical pathology practice, including various organ systems. The photos in this atlas have been collected over many years of practicing surgical pathology in one of the largest medical centers in the world, and include emphasis on important anatomic landmarks and explanations on how to properly orient, section and sample anatomic specimens. The use of actual gross images allows readers to more readily apply the grossing tips to actual specimens that they encounter at the grossing bench. Each chapter is arranged by organ system and includes essential tips for grossing each specimen and sample dictations with all the essential elements that must be addressed for proper assessment of each organ specimen. Written by expert pathologists, Atlas of Surgical Pathology Grossing is an excellent resource for pathologists, medical and pathology assistant students, residents, both in surgery and pathology, and pathology assistants.

In any histopathology department, cutaneous biopsies form the major part of the workload. In many instances these may be readily dealt with by experienced pathologists and their documentation represents an essential step in organising therapy. However, in a number of areas dramatic changes have occurred in dermatopathology. The rapidly changing incidence of pigmented lesions of the skin and the availability of diagnostic cell markers in the complex cutaneous lymphomas have meant that for many pathologists a review in these fields will be valu- able. The distribution and pattern of skin pigmentation may allow us to make important assertions and draw importantconclusions about the genetics of skin disease, but also about human variability. Cutane- ous vasculitis is a difficult problem where clinicopathological consulta- tion is vital in diagnosis and the review presented has been written with this verymuch in mind. In the same way, many diagnostic difficul- ties exist in assessing buttous lesions in the skin and for this reason a review was invited. Finally, our understanding of certain skin diseases has been radical- ly altered by knowledge of the dynamics of the changes seen, a field which has also beenstudied with advantage inother systemsin patholo- gy. This volume is intended as an aide to those many pathologists and dermatologists who, often together, are responsible for the pro- vision of clinical care in this demanding field. London C. L. BERRY Contents Melanoma and Other Melanocytic Skin Lesions. With 8 Figures D. WEEDON . Cutaneous Vasculitis.

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."

During the past ten years numerous new findings have been documented in the field of gynecological pathology, especially in respect of neoplasms. These findings have been generated by the application of recently developed techniques of immunology and molecular biology. However, clinicopathologic examinations. are still an absolute requirement for the morphologic evaluation of neoplasms, including gynecological tumors. The International Society of Gynecological Pathologists (ISGYP) has contributed greatly to the progress within gynecological pathology. The ISGYP Nomenclature Committee has promoted the International Histological Classification of Gynecological Tumors under the auspices of the W orid Health Organization. A new edition of the classification of tumors and tumor-like conditions of trophoblastic disease, uterine corpus, cervix, vagina, and vulva is currently in press. A second volume covering the ovaries, fallopian tubes, broad ligament, and female peritoneum will be published later. Organization of scientific symposia and seminars has also been an important activity of the ISGYP. The present editor organized and chaired a symposium entitled "Recent Progress in Diagnostic Pathology of Gynecological Tumors" held in Sendai, Japan on 11 April 1986 in close cooperation with Prof. T. Okagaki, University of Minnesota Medical School, and under the joint auspices ofthe ISGYP and the Japanese Society of Pathology. The following topics were discussed at this symposium: - Immunocytochemistry of gestational trophoblastic disease (Dr. R.J."