Gnepp DR, editor:

Diagnostic Surgical Pathology of the Head and Neck 888 pp, Philadelphia, W.B. Saunders, 2000 ($295.00).

This comprehensive textbook of head and neck pathology is aimed at surgical pathologists, otolaryngologists, oral surgeons, and anyone interested in this field of pathology. The impressive monograph for the new millennium is the most thorough review of head and neck pathology, including some topics that usually are lacking, such as thyroid, parathyroid, and lacrymal gland pathology. The internationally recognized authority of the editor and his 27 contributors provides an excellent guarantee for readers that the book succeeds in its stated aim of being a diagnostic guide in difficult problematic areas, although common lesions also are covered extensively. It actually fills a gap that has been noticed for many years by all those who follow contemporary developments or are more deeply involved in head and neck pathology.

The textbook contains 14 chapters and an appendix. The elegant format is illustrated with high-quality color and black and white macroscopic and histomorphologic pictures, radiographs, and quite a number of line drawings, which are of assistance in understanding the puzzling anatomy and relations of structures in this region.

The monograph provides a very important starting point for precancerous lesions of the upper aerodigestive tract (UADT). Diagnostic criteria, natural history, and terminological problems of ‘squamous intraepithelial neoplasia’ of the oral cavity and larynx are discussed in detail, showing the great differences and inconsistencies among current applicable grading systems. The authors, who have wide experiences on this topic, offer their approach of a two-grade system of laryngeal lesions. The whole significance of this problem would have been even more thoroughly presented if all aspects of different views had been referred to, including the four-grade Ljubljana classification of laryngeal lesions, which recently has been established successfully in Europe.

The second chapter extensively describes the most common malignant tumor of the UADT. Squamous cell carcinoma and its unusual subtypes are discussed adequately, as well as their particularities at various head and neck sites. The subsequent chapter, in which nonsquamous lesions of the nasal cavity, paranasal sinuses, and nasopharynx are covered, is distinguished by the accurate description of inflammatory disorders and tumorous lesions. The next two chapters describe mainly nonsquamous benign and malignant lesions of the oral cavity, hypopharynx, larynx, and trachea, referring also to epithelial papillary lesions of these sites. The role of laryngeal neuroendocrine and salivary-type tumors deserves special attention among laryngeal lesions. The most extensive chapter of the book consists of an outstanding review of salivary and lacrymal gland pathology. Differential diagnoses of salivary gland cancers are presented as promising guidelines for daily work. I call readers’ attention especially to chapter 10, in which a broad spectrum of differential diagnoses of cervical masses, including congenital, inflammatory, and neoplastic diseases, is discussed. The authors’ statement that pathologic diagnosis of the disease and treatment of these patients pose a challenge for both pathologists and head and neck surgeons is absolutely certain. Hematopathologic lesions in my experience remain one of the most difficult and vaguest fields of head and neck pathology. The review of non-Hodgkin’s lymphomas classified according to the Revised European-American Classification of Lymphoid Neoplasms enables head and neck pathologists, who usually are not experts in this field, to be adequately informed for daily work. The abundant, beautiful color photos in this chapter are particularly worthy of praise. Although there are few, if any, cutaneous neoplasms of the head and neck that are unique to this topographic area, this penultimate chapter will brush up a head and neck pathologist’s knowledge of this topic, focusing mainly on the morphologic features and diagnostic errors of the most frequent lesions. The appendix includes the TNM staging of the head and neck tumors proposed by the American Joint Committee on Cancer (1997). The extensive, updated bibliography at the end of each chapter adds further to the value of the book.

In summary, first of all my sincere congratulations to Dr. Gnepp and his contributors for a truly outstanding book. It is wonderful that head and neck pathology, which comprises one of the most heterogeneous areas of the human body, with different organ systems and so many pathologic entities, has finally gained its literary jewel. This all-embracing overview of the standard pathology, together with recent advances and discoveries that have occurred in the field of head and pathology in the past decade, will provide indispensable diagnostic guidelines to all those dealing with otolaryngic diseases. A book of this type is a must on the shelves of anyone, from residents to seniors, involved in head and neck pathology, and all medical libraries should similarly place it among their gold standard textbooks.