Endocrine Pathology

“The heart has its reasons, and the endocrines have theirs.” — Aldous Huxley, in Island Endocrine diseases are complicated. Many of these diseases affect several organs. Some have familial connotations; a few are diagnosed biochemically; and others are identified only through biopsy. Aggressive-appearing lesions may behave in an innocuous manner, and bland-looking neoplasms can metastasize. Regardless of our current ability (or inability) to understand all the reasons of the endocrines, appropriate pathologic testing and precise diagnosis remain central to their management. The aptly entitled Endocrine Pathology is divided into 30 chapters that are arranged in three parts. The first part—the shortest—provides a summary of the clinical aspects of endocrine diseases (and includes several informative algorithms). The second part covers the investigative techniques utilized to study endocrine disorders and organs (including cytological and intraoperative assessments). The third part—the longest—provides wide-ranging coverage of the anatomical (mainly organ-based) aspects of endocrine disorders. The exhaustive coverage in this book is provided by 62 multinational authors—most of whom are based in Canada and Turkey. Some notable experts in the field are among the contributors. Not surprising, the thyroid gland secures the most coverage. In general, other organs get coverage mostly appropriate to their prevalence and importance. There are other chapters that deal with seemingly esoteric topics such as “the brain as an endocrine organ” and even “soft tissue in endocrine disease.” The chapter “Morphology and Immunohistochemistry” ought to be considered essential reading for the surgical pathologist-in-training. This chapter contains rational reminders (eg, “microscopy is the foundation of modern pathology”). Practical pointers are present elsewhere (eg, “any parathyroid gland that weighs more than 60 mg and measures more than 1.0 cm should be considered an abnormally enlarged gland”). Our understanding of endocrine diseases, particularly of their molecular aspects, is evolving briskly. Thus, there are sections entitled “Molecular Anatomy” in several chapters that impart potentially useful leading-edge information (eg, “cardiac hypertrophy is associated with re-expression of genes for fetal proteins…”). The text is mostly cogent. Some statements may confuse the novice (eg, “microfollicles are not simply small follicles”). Numerous illustrations effectively complement the text, although some images are superfluous (eg, accessioning of a frozen section specimen), and a few could have benefited from a more descriptive legend (eg, Figure 13.72, depicting vascular invasion in thyroid neoplasms). Endocrine Pathology has been promoted by its publishers as a “comprehensive and up-to-date book” and “the definitive resource on endocrine pathology for all pathologists, endocrinologists, and researchers.” This claim appears, for the most part, to be valid because the book effectively covers the myriad biochemical, clinical, cytopathological, familial, histopathological, immunohistochemical, immunological, radiological, molecular, and several additional aspects of nonneoplastic and neoplastic diseases that involve the hormone-producing organs.

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