BDo we still need Textbooks? After all, it is common practice to solve everyday’s pressing problems through dedicated websites.^ This is the first, basic question which comes to mind when… Click to show full abstract
BDo we still need Textbooks? After all, it is common practice to solve everyday’s pressing problems through dedicated websites.^ This is the first, basic question which comes to mind when dealing with BDabbs’ Immunohistochemistry,^ now reaching the 5th Edition. Not a manual, but a massive book (900+ pages, over 3000 figures, an infinite number of references, most of them to be retrieved online in order not to overweight the text). No doubt, the expansion along the different editions of this classical textbook represents the reflection of the inflationary evolution of the discipline, originally considered as an Bancillary^ technique reserved for scientific academic research and it represents a testimony of the explosive evolution of immunohistochemistry (IHC) towards diagnostic, prognostic, theragnostic, and genomic applications. The general philosophy of the book is that the scientific and clinical role of pathology (and pathologists) is steadily evolving. This represents a chance and a challenge for the discipline, since modern precision medicine requires a precision pathology (and pathologists). Intricacies in the algorithmic use of markers require that specialists in different areas were needed and they were called in and contributed with wide and deep experience. The related risk of dispersion was, in my opinion, positively solved, since 4 of the 23 chapters dealing with pathology of different organs and apparatuses had David Dabbs as one of the authors, and in the other chapters, one can recognize a common approach: a steady link with morphological patterns, a list of markers which emerged as most useful and predictive, mention of related caveats and pitfalls and finally a sound opinion dictated by practical experience. The fact that most authors are working in the same institution, in Pittsburgh, is no surprise. I fully read 5 chapters (N. 1, 8, 10, 19, and 21), single parts in all the others and asked colleagues to go through areas of their specific interest (the one on Haematopathology by prof. Alberto Zamò). We have been appreciating the update of the information, the dual approach (on single pathological entities and on specific markers of interest), the algorithmic approach, and the concise presentation of key points. The practice of IHC is in the present time fully dependent on commercialized reagents and apparatuses and the book offers advice that in my opinion is fair and unbiased, to achieve the ultimate goal of obtaining reproducible and reliable results. Practical advice is offered on how to use antigen retrieval and heating procedures, and on the advantages and risks of automation. Pathologists are now increasingly involved in the selection among different commercial offers and sound suggestions are here presented in order to avoid sub-optimal results and discrepancies among laboratories. I found particularly objective and balanced the information regarding automation and the new prospects for IHC, on the way of transit from an academic discipline to a fully reliable and consistent analytical procedure, so as to build up a companion diagnostic, providing information essential for the safe and effective use of a corresponding therapeutic procedure and in the selection of proper (personalized) treatments. If I have to raise a criticism, it is not on the book (out of so many quotations, all of them updated, and pictures, only a figure was to be out of focus (fig. 17.12)), it is to this magnificent monument which looks to me like a giant with feet of clay, since it is all based on poorly standardized pre-analytical factors and on the use of formalin fixation. Pathologists shall have to standardize the procedures, and it seems predictable that sooner or later we shall have to abandon a presently unavoidable but toxic reagent. However, Pathologists already overcame apparently insurmountable technical barriers. The trend is towards making IHC a fully reliable and dependable procedure, and this book correctly addresses how to reach this goal. Dabbs’ Immunohistochemistry is specifically designed for practicing diagnosticians, but it is not only going to be supportive for selecting proper tests for the differential diagnosis among morphologically similar entities. It outlines the * Gianni Bussolati [email protected]
               
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