Atlas of Diagnostic Cytopathology: Second Edition

Those who are interested in cytology, at all levels of experience, are notoriously fond of atlases. The neophyte nourishes a belief that a set of images and (relatively) brief text will quickly lead to competence, whereas the expert hopes that there will be help with a difficult diagnostic problem, or the aesthetic enjoyment of images more beautiful than any in their experience. The “Atlas of Diagnostic Cytopathology” (second edition) edited by Barbara F Atkinson alludes to these disparate audiences in the preface, stating that the work is for “cytopathology residents, fellows, cytotechnology students, and ….experienced cytopathologists”. The first two categories are likely to judge a book by its brevity and clarity, and the last by comparison with their favourites of the genre, such as the works of Orell, DeMay, or Lopes Cardozo.

By anyone’s criteria Atkinson’s atlas is a worthwhile addition to the diagnostic cytology armamentarium. In many respects it is excellent, although a slight unevenness, perhaps inevitable in any multiple author work must be acknowledged. Its text, authored by an impressive array of experts in the field, although laudably concise, is comprehensive in its breadth. It effectively covers basic information, such as the diagnostic approach to a smear, in addition to the most recent ancillary techniques, such as fluorescent in situ hybridisation and laser scanning cytometry. It is timely and useful, but unfortunate, that the breadth of coverage also extends to a discussion of medicolegal liability in the practice of cytology.

The images, central to the purpose of this work, are almost universally of high quality, both in terms of their initial acquisition and reproduction. The source of the images, the collections of the many authors, inevitably leads to some inconsistencies. I found the occasional image dark, light, “milky”, or poorly focused, and rarely found an example of a picture that did not really illustrate, in my opinion, any characteristic feature of the entity it purported to represent. But for the aficionado there is plenty of lagniappe here, from beautiful images of humble observations (such as Spinnbarkeit in a cervical smear) to rare fine needle aspiration samples of follicular dendritic cell sarcoma and other unusual neoplasms.

This work, despite its imperfections, does span the utility gap between the beginner and the expert and will be useful in both large academic and small departments.