Practical Pulmonary Pathology: A Diagnostic Approach Fourth Edition

Practical Pulmonary Pathology: A Diagnostic Approach (Pattern Recognition) 4th Edition

It is often stated that anatomic pathologists come in two forms:
“Gestalt”-based individuals who recognize visual scenes as a whole
and match them unconsciously with memorialized archives; and cri-
terion-oriented people who work through images systematically in
segments and tabulate 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 specifically 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 textbook
titled 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 suc-
cessfully segregate pathologic conditions into diagnostically and clini-
cally 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, “imitation is the sincerest form of
flattery,” since our book came out, other publications and presentations
have appeared in our specialty and have used 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
Series Preface
to accomplish that task. Because a panoply of patterns is difficult to
approach mentally from a practical perspective, we have asked our
contributors to be complete and yet to discuss only principal interpre-
tative images. Our goal is to eventually provide a series of monographs
that, in combination with one another, will allow trainees and practi-
tioners in pathology to use salient morphologic 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 can often narrow diagnostic possibilities to a very few entities
using the pattern method, and sometimes a single interpretation will
be obvious. Both of those 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
Elsevier series, will be beneficial to our reader-colleagues.
Kevin O. Leslie, MD
Mark R. Wick, MD