Practical Hepatic Pathology A Diagnostic Approach 2nd Edition (A Volume in the Pattern Recognition Series)

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Practical Hepatic Pathology A Diagnostic Approach 2nd Edition (A Volume in the Pattern Recognition Series) PDF

It is often stated that anatomic pathologists
come in two forms: “Gestalt”-based individu-
als, who recognize visual scenes as a whole,
matching them unconsciously with memorial-
ized archives, and criterion-oriented people,
who work through images systematically in
segments, tabulating the results—internally,
mentally, and quickly—as they go along in
examining a visual target. These approaches
can be equally effective, and they are probably
not as dissimilar as their descriptions would suggest. In reality, even
“Gestaltists” subliminally examine details of an image, and if asked spe-
cifically about particular features of it, they are able to say whether one
characteristic or another is important diagnostically.
In accordance with these concepts, in 2004 we published a text-
book entitled Practical Pulmonary Pathology: A Diagnostic Approach
(PPPDA). That monograph was designed around a pattern-based
method, wherein diseases of the lung were divided into six categories
on the basis of their general image profiles. Using that technique, one
can successfully segregate pathologic conditions into diagnostically
and clinically useful groupings.
The merits of such a procedure have been validated empirically by
the enthusiastic feedback we have received from users of our book. In
addition, following the old adage that “imitation is the sincerest form
of flattery,” since our book came out other publications and presenta-
tions have appeared in our specialty with the same approach.
After publication of the PPPDA text, representatives at Elsevier, most
notably William Schmitt, were enthusiastic about building a series of
texts around pattern-based diagnosis in pathology. To this end, we have
recruited a distinguished group of authors and editors to accomplish
that task. Because a panoply of patterns is dif-
ficult to approach mentally from a practical
perspective, we have asked our contributors to
be complete and yet to discuss only principal
interpretative images. Our goal is eventually to
provide a series of monographs that, in combi-
nation with one another, will allow trainees and
practitioners in pathology to use salient mor-
phologic patterns to reach with confidence final
diagnoses in all organ systems.
As stated in the introduction to the PPPDA text, the evaluation of
dominant patterns is aided secondarily by the analysis of cellular com-
position and other distinctive findings. Therefore, within the context
of each pattern, editors have been asked to use such data to refer the
reader to appropriate specific chapters in their respective texts.
We have also stated previously that some overlap is expected
between pathologic patterns in any given anatomic site; in addition,
specific disease states may potentially manifest themselves with more
than one pattern. At first, those facts may seem to militate against the
value of pattern-based interpretation; however, pragmatically they do
not. One often can narrow diagnostic possibilities to a few entities
using the pattern method, and sometimes a single interpretation will
be obvious. Both outcomes are useful to clinical physicians caring for
a given patient.
It is hoped that the expertise of our authors and editors, together
with the high quality of morphologic images they present in this Else-
vier series, will be beneficial to our reader-colleagues.
Kevin O. Leslie, MD
Mark R. Wick, MD

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