D. Meuten – Tumors in Domestic Animals (2017)

Описание

Preface

Dr. Jack Moulton would be very pleased that his book is in its fifth
edition. He would welcome the return of color: it was present in the
first edition in 1961. The quality of images between editions is not
to be compared, but it is interesting and enlightening to compare
old color and B&W images of the same tumors and leukemias
with current images. The names of many tumors have changed
and subtypes have emerged as we uncovered more about their true
identity and behavior, at least with present day techniques. This
will happen in every edition and is a credit to diagnosticians and
investigators around the world. Past and present authors are part
of the group that produced these discoveries. The present authors
have summarized and detailed this body of information for pathologists,
oncologists, molecular biologists, cancer biology investigators,
veterinarians, and students of veterinary medicine. The authors
have provided exquisite color images or created collages that pictorialize
diagnostic features, pathogenesis, and techniques. Some
images correlate radiographic, MRI, or CT studies with gross and
histologic lesions, while others depict immunohistochemical,
molecular, or cytological characteristics. Images provided by colleagues
from around the world greatly improved this book, and
their contributions are credited in legends. I hope readers note
these contributors and realize how much the authors and I appreciate
their willingness to share their expertise in pathology and photography.
Images are an integral part of this book and pathology;
they summarize and capture what words attempt to describe.
Technology and its application are responsible for much of the
new information in all disciplines. The authors have done an excellent
job of blending core, basic pathological tenets that will remain
constant with new information uncovered by evolving technology.
There are new authors, new chapters, and a tremendous volume
of new information that is cited, reviewed, and summarized in a
reader‐friendly and practical manner. However, an evaluation of
contents is the job of readers and reviewers, not of an editor proud of
the book and friend of the contributors. I am proud of the contents
because of the quality of work that authors so willingly gave for so
little material reward. When you see them at meetings please thank
them – it will mean more coming from you than me. The value of
this book is due to their hard work in each chapter and throughout
their productive careers. I am greatly indebted and thankful to them,
as shall be our colleagues and patients in our clinics.
The book remains focused on diagnostics, biologic behavior of
animal cancers, and oncogenesis. An overview of all the tumors
within each body system is provided via text, tables, and images.
This feature is why books still have value in the age of on‐line
everything. Authors also provided insights on how they differentiate
tumors that appear histologically similar. Because of the desire
to treat cancer in pets it is a reality that journal publications and
a large component of this book are now focused on dogs and cats.
Accurate morphological diagnoses and determination of prognostic
parameters are required for the selection among numerous treatment modalities currently available. Although accurate tumor
diagnosis and classification often requires multiple techniques,
histopathology and cytology remain the foundation of diagnostics.
Authors have integrated the growing body of discovery with the
practical components of our work. Providing prognostic information
based on histological findings is an expected part of pathologists’
assessments but this text has not delved into treatment options as
clinical oncology rewrites these approaches weekly. Often, clinicians
value margin assessment as much or more than the diagnosis.
There is a chapter dedicated to this topic and trimming biopsy
specimens for histologic examination.
Tumor cytology has been added and will continue to expand in
subsequent editions. For many tumors, cytology is as accurate as
histopathology, can be used at patient side with minimal invasiveness,
and can yield specimens for molecular studies. Grading schemes
based on cytology and molecular profiles will be included in future
editions. Cytological evaluation can replace biopsy for some osseous
tumors, and if treatments beyond excision or palliative measures
are not a consideration, then cytology can provide a final diagnosis
for many solid tumors and most leukemias. Reference texts in the
tissue and cytological diagnostic arenas are largely divorced, and
integration of these can benefit morphological assessments of
cancer disease. Furthermore, cytological assessment permits rapid
turnaround time and will become same day when representative
cytological images are sent from patient side to pathologists.
Immunohistochemistry is now a routine part of our diagnostic
evaluation and a chapter is dedicated to this topic. Authors emphasize
it is only one part of the diagnostic puzzle. IHC, PARR, molecular
signatures, and other ancillary tests must be integrated with all
the other data available; they are not stand-alone tests. We need
these tests most when the interpretation of light microscopy is not
straightforward, yet that is when ancillary tests may also be ambiguous.
We should convince clinicians of this and we need standardization
of methods. The tsunami of molecular diagnostics has not
yet washed away H&E. Molecular tools to create signatures that differentiate
tumors, detect cancers at the earliest possible intervention,
elucidate oncogenesis, or become independent prognosticators
are exciting developments. In addition to the molecular characteristics
of tumors, the next generation of prognostic tools will look at
the host’s ability to respond to cancers. It is likely that the host’s
response will be as or more predictive of biologic behavior for many
tumors than is assessment of margins, mitotic counts or immunohistochemical
profiles. It will be terrific when tests identify whether
a patient is likely to develop cancer, which cancer is likely, which
treatment is best, and how innovative techniques (e.g., CRISPR) can
be directed to treat the cancer. Cost accountability will always be a
component of veterinary diagnostics and care.
I doubt reviewers will find much controversy in this book. There
may be some diagnoses or a pathogenesis that others may not
accept, but not many. If anything is controversial it may be in the
appendices, where I tried to summarize information so it can be
easily found and used. However, without standards for the diagnostic
parameters to predict behavior or standardization of the
techniques used, it is difficult to compare studies or merge data
from different reports. Users are encouraged to read the original
references for the many excellent details they provide.
We need standardization of diagnoses, techniques, and our
follow-
up assessments in veterinary oncology and oncologic
pathology. Some would say this book is the standard with which
to diagnose cancers in domestic animals. However, the techniques
used to provide diagnoses need standardization, such as antibodies,
primers, margins, areas in which mitotic figures are
counted, and flow cytometry. Without standards for the diagnosis
and techniques employed we cannot reliably compare results between
studies and contradictions of prevalence, biological behavior,
and diagnosis will continue. Standardization of outcome assessments
is imperative, yet it may be the weakest link in the connection
of histologic,
cytologic, and molecular parameters with
prognosis. Documentation of tumor recurrence with histopathological
confirmation and autopsy data is essential to assess a
tumor’s biological behavior. Unfortunately the number of published
case series reported with autopsy and histopathology is
abysmally small. If veterinarians want to rely on information from
investigative studies to help owners and their pets, they need to
help collect accurate follow-up data. We need to train our new
veterinarians that, in addition to being competent surgeons, clinicians,
and caregivers, they have a responsibility to serve the profession
as clinical scientists too.
All of us are indebted to mentors. They taught us, they nurtured
our passion for pathology and were role models for each new generation
of veterinary pathologists. The authors and readers of this
book double‐scoped and learned from some of the founders of
veterinary pathology, and I dedicate this book to mentors. Many are
icons in our disciplines but many of us benefitted enormously from
hard‐working and committed teachers who were not so widely
known, but were essential to us. If I listed names I would forget
some and offend others so please take a moment to think about
those individuals who shaped you and your career. We all remain
responsible for passing on this mantle.
We have not defeated cancer. That stated goal from many years
ago did not acknowledge the complex biology of cancer. No one
could have predicted the information about cancer would grow to
the enormity it has. Despite all the time, money and great minds that
have investigated cancer it remains a leading cause of death in animals
and people. The discipline of oncology will expand in human
and veterinary medicine and professionals from both disciplines
should work together to understand how cancers develop and how
to better fight them. Veterinarians, physicians, and researchers need
a book like the one Dr. Moulton envisioned. This book would not be
a reality without Wiley and the executive editor, Erica Judisch, and
the freelance project manager Nik Prowse. An unseen person who
helped throughout was Laura Cullins; she solved the many problems
that arose and made my job easier. Many wanted this edition
published sooner, none more so than my wife; thank you Nicki