Preface to the second edition

Many of the introductory comments in the first edition of this book regarding the increasingly focused approach required of pathologists to surgical cancer histopathology reports still pertain. In the intervening period a number of trends have continued to develop that have required an update.

• system-specific cancer multidisciplinary meetings with specialized clinicians and appropriate pathological, radiological and oncological support. Increasingly these meetings require fewer pathologists reporting significant numbers of relevant cases rather than a large number of pathologists reporting them only sporadically. From this has arisen cancer-specific lead pathologists encompassing a spectrum of specialist differentiation from "monospecialists" to "generalists with an interest in" and variations in between. Cancer report datasets aimed at maintaining overall standards of reporting are freely available published by various bodies, viz the Royal College of Pathologists, the Association of Directors of Anatomic and Surgical Pathology and the College of American Pathologists. In the UK the Royal College Datasets are a model for standardized reporting and their success is measured by their ongoing revision and second cycle of publication. No doubt specialist and team reporting will increase, particularly as the parameters for each cancer type report become more complex. Datasets with their notes and attendant information are required not only to update pathologists but also to keep them aware of significant pathology in other areas that might impact on their own specialization, e.g. metastatic carcinoma. Availability as PC-based templates also facilitates reporting, audit and download to cancer registries.

• in immunohistochemistry there is an ever-expanding range of increasingly robust antibodies which, with antigen retrieval methods, are applicable to surgical histopathology material. Panels of these antibodies not only help to identify the tumour type and subtype but can also give prognostic information as to the likely biological outcome and response to hormonal or chemotherapy. The data change rapidly, often with supposedly cancer type-specific antibodies becoming less so with time but still useful in combination with other putatively positive and negative markers in a panel. It can be difficult for the pathologist to keep abreast of current information in this field and which antibodies to use that will give reliable results.

• increasing multi-professional team working in the laboratory necessitates provision of core information to Biomedical Scientists as a basis for why we do what we do and how we do it in reporting surgical cancer histopathology specimens, particularly in relation to supervised role delegation such as specimen dissection. This knowledge base is also necessary to students and trainees, given the changes that have occurred in the undergraduate medical curriculum, in postgraduate medical training and the pressures on academic pathology.

• the 6th edition UICC TNM Classification of Malignant Tumours and the 5th edition UICC TNM Atlas have been published.

This text aims to augment and complement dataset reporting for surgical cancer histopathology specimens. Hopefully it highlights the main diagnostic and prognostic criteria for the common cancer types but also provides diagnostic clues for differential diagnoses and characterizes typical immunophenotyping. The author gratefully acknowledges the use of illustrations from Wittekind C, Greene FL, Hutter RVP, Klimpfinger M, Sobin LH (eds) TNM Atlas: Illustrated Guide to the TNM/pTNM Classification of Malignant Tumours. 5th edition. Springer. Berlin Heidelberg 2004.

I would also like to express my appreciation of the support from my colleagues at the Belfast City Hospital Histopathology Laboratory and thanks to my co-authors in Derek C Allen, R Iain Cameron (eds) Histopathology Specimens. Clinical, Pathological and Laboratory Aspects. Springer. London 2004 - Tong Fang Lioe, Seamus Napier, Roy Lyness, Glenn McCluggage, Declan O'Rourke, Maurice Loughrey, Damian McManus, Maureen Walsh, Kathleen Mulholland, Richard Davis, Lakshmi Venkatraman and Peter Hall.

Thanks also to Melissa Morton, Eva Senior and the staff at Springer, my secretary Michelle McLaughlin (I don't know how you read the writing!), and, last but most of all, my wife Alison and our girls Katie, Rebecca and Amy.

Derek Allen Belfast

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