Epstein JI, editor: The Johns Hopkins Atlas of Surgical Pathology, CD ROM, London, Churchill Livingstone, 1999 ($210.00).

Electronic publishing is ever expanding. The Johns Hopkins Atlas of Surgical Pathology is another entry into this nascent field, which is inextricably changing the way we assimilate the written word and captured image. The application program is Windows and Macintosh compatible, requiring a minimum of 12 MB of RAM, 8 MB of disk space, and a 16-bit color monitor. The clock speed only needs to be above 66 MHz. The program runs under most versions of Windows, including NT and Me.

The atlas consists of a single CD-ROM containing 4000 images stored as PDF files of approximately 156 KB. Adobe Acrobat Reader is used to open these files, but they can be accessed by Photoshop and converted to a form suitable for PowerPoint presentations. The Folio Corporation supplies the mechanics of the disk. Installation is tedious and requires loading Acrobat Reader 3.0, Folio Bound, and Apple Quick Time. All files can be loaded onto your hard disk (656 MB), but this process is exceeding slow. Once accomplished, however, one can run the Atlas without the CD in place. The program is easy to use, and navigation is intuitive. However, for the uninitiated, there is a distinct difference between single and double mouse clicks in the operation of the program. The Atlas has a so-called recognition mode and a quiz mode. Search capabilities and hyperlinks are straightforward. Image quality is good.

Ignoring all the bells and whistles, the true measure of any volume is content. In this instance, the Atlas of Surgical Pathology can best be described as inclusive but not necessarily comprehensive. Most topics contain something for everyone, but there is rarely any discussion of pathophysiology. On the other hand, this is an atlas and not a textbook. The section on medical kidney is restricted to light microscopic images. Cryoglobulinemia mentions only two types of cryoglobulins and fails to describe clonality. The section on malignant mesotheliomas makes reference to calretinin but ignores the use of CK7, CK5/6, and thyroid transcription factor. Conversely, the paragraph on synovial sarcoma does reference the characteristic X:18 translocation.

Overall, the restricted depth of the Atlas will limit its audience. The breadth of coverage, however, will meet the needs of most medical students and junior residents. Experienced pathologists will find the material most useful as an outline and image archive for teaching and presentations.