Practical Cytopathology: A Diagnostic Approach to Fine Needle Aspiration Biopsy, a 560-page hardcover book by Andrew S. Field and Matthew A. Zarka, is available for purchase and also includes an eBook version at no additional charge. This book focuses on a systematic process of identifying lesions by using a pattern-based recognition approach to fine needle aspiration biopsy slides at low power magnifications, and followed by high power confirmation. The book is full of information, but is also very approachable, making it an ideal reference book for those in the field of cytopathology.

There are 11 chapters within the book, and each covers a different body site commonly biopsied by FNA. Early in each chapter, an overview of the organ system is given. These overviews include the reasons and indications for performing the procedure, as well as the current role the FNA plays in each particular site. Advantages, difficulties, and any applicable rules for specimen adequacy are also discussed, giving readers valuable insight into the current standards of care of the procedure.

Pattern based recognition of lesions is the focal point of the book, and each chapter centers on the idea by introducing the most common smear patterns seen for each particular body site. Smear patterns are the low power (2x, 4x, 10x, and 20x magnification) view of FNA smears, and their key elements and details are brought to attention. They are presented through photomicrographs, and are further supplemented by an accompanying cartoon illustration. The illustrations and descriptions help to emphasize the components that can be seen in each pattern, which should prove helpful to those new to cytopathology.

After introducing the patterns, the most common lesions found in each body site are discussed. The lesions range from inflammatory processes to malignant neoplastic entities. All lesions are thoroughly explained, and the discussions include the corresponding smear pattern, clinical features, cytopathologic information, differential diagnoses, and any applicable diagnostic ancillary tests. Conveniently, the authors also provide each entity with a small section that lists the associated pattern and cytologic criteria. This section is highlighted and the list is bulleted for quick and easy referencing. After determining the pattern of a smear, cytologic features must be confirmed at high power to come to an accurate diagnosis. Having the criteria listed and so easily available at a glance is very helpful.

In addition to aiding in routine FNA biopsy evaluation, using this method can also be helpful during rapid onsite assessments. Specimen adequacy is the primary goal of these assessments, but being able to identify a type of lesion as soon as possible at low power can be helpful with triaging samples for ancillary testing, especially if the number of passes a clinician can make are limited. A timely assessment can utilize all obtained samples and benefit the overall quality of patient care.

This systematic approach of pattern recognition provides a methodical way of identifying lesions by FNA smears. The book introduces the patterns and discusses lesions in a way that is simple to follow and quick to refer to. Both the photomicrographs and illustrated cartoons are of high quality and well representative of the elements meant to be highlighted. The system that this textbook teaches is efficient and effective, and can be helpful to students and professionals in the field. This book would make a valuable addition to any cytology library.

Ronald Encarnacion, CT(ASCP), The ASC Bulletin Editorial Board
Virginia Commonwealth University
Richmond, Virginia