McLendon RE Bigner DD Bigner SH Provenzale JM:

Pathology of Tumors of the Central Nervous System. A Guide to Histologic Diagnosis, 313 pp, London Arnold, 2000 ($179.50).

This book has been designed as a practical diagnostic manual and atlas and serves as a companion text to the sixth edition of Russell and Rubinstein’s Pathology of Tumors of the Nervous System. For this endeavor, two of the editors of Russell and Rubinstein have been joined by the pathologist Sandra Bigner and the neuroradiologist James Provenzale.

The book is divided into three main sections: mass lesions in adult brains, mass lesions in brains of children and young adults, and brain tumors of maldevelopmental origin. Given this approach, a certain degree of overlap is inevitable, and this is reflected in the discussion of glioblastoma. However, in considering the differential diagnosis for the different age groups, this approach works very well. Most entities have a highlighted table of the salient epidemiological and pathological features. There are also very useful tables for mimics of fibrillary astrocytoma, melanocytic lesions, and cystic lesions of the central nervous system. Newer entities such as the papillary glioneuronal tumor, atypical teratoid tumor, solitary fibrous tumor of the meninges, and the desmoplastic infantile tumors (ganglioglioma and astrocytoma) are also included.

The discussion stresses features of practical diagnostic importance, the use of immunohistochemical markers, and the value of Mib 1 labeling in assessing proliferative potential. The molecular biology of brain tumors is not addressed, and this appears entirely justified given the practical diagnostic bias of the book. The text is well organized and packs in considerable detail for an atlas format and also includes selected references. The discussion pertaining to high-grade astrocytomas of children and young adults is particularly good and highlights the problems in differential diagnosis in this group.

The book is generously illustrated with high-quality photographs of gross and microscopic pathology, and neuro-imaging illustrations greatly enhance the value of this atlas. Given its practical bias, this book is a valuable addition to the standard texts on pathology of central nervous system tumors. In many ways, it is likely even more useful as a ‘bench’ text for pathologists in the diagnosis of brain tumors.