Wendy L.FrankelDaniela M.ProcaFrozen Section Library: Pancreas2011SpringerNew York, New York978-1-4419-7789-296 pp. $139.00. Web address for ordering: www.springer.com

Abstract

The stated goal for books in this series is “to provide convenient, user-friendly handbooks for each organ system” to expedite frozen section diagnosis. This 96-page paperback book is divided into 8 chapters. The general discussion and assumptions regarding frozen section diagnosis stated in the prefaces and introductory chapters are insightful and on target. In particular, the focus on the surgeon's perspective in Chapter 2 is valuable (a surgeon, Mark Bloomston, is co-author for this chapter). Subsequent chapters focus on histopathologic diagnosis by frozen section with separate chapters that deal with the distinction between pancreatic ductal adenocarcinoma and chronic pancreatitis, variants of pancreatic adenocarcinoma, cystic lesions, other pancreatic neoplasms including neuroendocrine (islet cell) tumors, secondary neoplasms, and issues of resectability and margins. The book is generously illustrated, with >150 high-quality color photomicrographs and several diagramed algorithms. It is not clearly stated whether the photomicrographs are made from the tissue as frozen and stained at the time of surgery, or whether they are derived from permanent sections made from fixed, paraffin-embedded tissues used for frozen section, or from other portions of the resected specimen. Examination suggests that some images were derived from each source. It also seems that the images are from incisional biopsies rather than from Trucut or fine-needle biopsies. The absence of a discussion of the role and merits of open versus needle biopsy is conspicuous. Nonetheless, this wealth of images is a major strength of the book. One minor lapse in the presentation of images occurs in Chapter 3, where some images and their legends are presented on the opposite sides of a single page rather than on the same or facing pages as is done elsewhere. This inconvenience can be laid at the feet of the production staff rather than attributed to the authors. Some of the low-power photomicrographs are presented as 34 × 46 mm images—so small that it is difficult to see the histologic detail described in the legend. Some of the “large” photomicrographs (47 × 63 mm) are provided at such low magnification that they present the same challenge. The key diagnostic features of autoimmune pancreatitis are listed in the text on page 9 but no figures are included. This is an unfortunate omission because autoimmune pancreatitis exhibits distinctive histologic features, is responsive to steroid therapy, and is not an indication for pancreatic resection. Autoimmune pancreatitis and paraduodenal (groove) pancreatitis are identified as major contributors to resection of pancreases for suspected malignancy. The senior author is an experienced surgical pathologist with a partial focus on pancreatic and hepatobiliary pathology. Publications by the junior author reflect a similar focus and several are co-authored with Dr Frankel, including a 2002 paper on frozen section diagnosis of pancreatic lesions. The authors are well qualified. Although there have been a few journal articles and reviews on frozen sections of pancreas, it seems that this book provides the most extensive coverage and collection of relevant images available for the topic. Overall, this book will be useful for training residents in surgical pathology, and as a resource for pathologists who do frozen sections. It is small and lightweight enough to take to the frozen section suite.