Surgical Pathology Dissection: An Illustrated Guide ...

1 Surgical PathologyDissection:An Illustrated Guide ,Second EditionWilliam H. Westra, , et Pathology DissectionSecond EditionSurgical PathologyDissectionAn Illustrated GuideSecond EditionWilliam H. Westra, Ralph H. Hruban, of PathologyDepartment of PathologyThe Johns Hopkins UniversityThe Johns Hopkins UniversitySchool of MedicineSchool of MedicineBaltimore, MarylandBaltimore, MarylandTimothy H. Phelps, Christina Isacson, of Art as Applied to MedicineDepartment of PathologyThe Johns Hopkins UniversityVirginia Mason Medical CenterSchool of MedicineSeattle, WashingtonBaltimore, MarylandWith Forewords by Frederic B.

2 Askin, 58 IllustrationsWilliam H. Westra, H. Hruban, of PathologyDepartment of PathologyThe Johns Hopkins HospitalThe Johns Hopkins HospitalThe Weinberg Cancer Building, Room 2242 The Weinberg Cancer Building,401 North BroadwayRoom 2242 Baltimore, MD 21231-2410, USA401 North BroadwayBaltimore, MD 21231-2410, USAT imothy H. Phelps, Isacson, of Art as AppliedDepartment of Pathologyto MedicineVirginia Mason Medical CenterThe Johns Hopkins University1100 Ninth Avenue, C6-PathSchool of MedicineSeattle, WA 98101, USA1830 East Monument Street,Suite 7000 Baltimore, MD 21205-2100, USAC over illustration:Extrahepatic biliary tract resection for carcinoma of the common bile by Timothy H.

3 Of Congress Cataloging-in-Publication DataSurgical Pathology dissection : an Illustrated Guide /[edited by] William H. Westra ..[et al.]. 2nd ; bibliographical references and 0-387-95559-3 (s/c: alk. paper)1. Pathology , Surgical Laboratory manuals. 2. Human dissection Laboratory manuals. I. Westra, William H.[DNLM: 1. Pathology , Surgical Laboratory dissection Laboratory Manuals. WO 142 S9615 2002]RD57. S87. 2002617 .07 dc212002029448 ISBN 0-387-95559-3 Printed on acid-free paper. 2003, 1996 Springer-Verlag New York, rights reserved.

4 This work may not be translated or copied in whole or in part without thewritten permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, NewYork, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly in connection with any form of information storage and retrieval, electronic adaptation,computer software, or by similar or dissimilar methodology now known or hereafter developedis use in this publication of trade names, trademarks, service marks, and similar terms, even ifthey are not identified as such.

5 Is not to be taken as an expression of opinion as to whether ornot they are subject to proprietary the advice and information in this book are believed to be true and accurate at the dateof going to press, neither the authors nor the editors nor the publisher can accept any legalresponsibility for any errors or omissions that may be made. The publisher makes no warranty,express or implied, with respect to the material contained in the United States of New York Berlin HeidelbergA member of BertelsmannSpringer Science+Business Media GmbHTo the Breakfast Club.

6 Fond memories of hooping it the team: Sharon, Caryn, Janine, and H. WestraTo my wonderful wife, Claire, and our three terrific children, Zoe,Emily, and H. HrubanTo my wife, Lyn, for her ever-present love and support; my twochildren, Katie and Kevin, who bring me great and constant joy;my art instructors of the past for all they have shared with me; and,particularly and most importantly, my Father; and in loving memoryof my H. PhelpsTo my sisters, Charlotte and IsacsonThis page intentionally left blank viiForeword to the Second EditionIt is a pleasure, an honor, and a distinct privilege to write the foreword forthe second edition ofSurgical Pathology dissection : An Illustrated to see that my predictions were accurate in regard to this effectiveand useful book.

7 It has become an extremely popular dissection manualwith regard to both its text and illustrative material. In fact, the manual andits medical illustrator, Timothy H. Phelps, received the Illustrated BookAward from the Association of Medical Illustrators in 1996. Pathologistreviewers have uniformly characterized the text as valuable and inclusivewhile still leaving room for individual variation in specimen as our other clinical colleagues continually endeavor to improve pa-tient care by adding new diagnostic tests and techniques, it is incumbent onanatomic pathologists to do the same.

8 The authors goal in the developmentof the second edition of this manual was not to replace the first editionbut, rather, to build on its strength. In this second edition, one finds theaddition of new coauthors with recognized expertise in their respective fieldsof interest. These coauthors have provided chapters on contemporarytopics not covered in the first edition and new illustrations (the specifics arelisted in the Preface). In addition, a number of the original illustrations,such as the breast specimen dissection , have been significantly revised andimproved.

9 In an attempt to provide more uniform description and tumorstaging, the existing chapters have been updated to conform with the recentlypublished College of American Pathologists (CAP) and Association of Direc-tors of Anatomic and Surgical Pathology (ADASP) basic goals for the first edition have been retained: to provide anaccurate, concept-oriented, easy-to-use manual that provides a logical,concise approach to the most commonly encountered specimens. Althoughnew authors and new material have been added, the basic solid frameworkof the manual persists.

10 I am confident that the second edition providessignificant improvements and that this manual will continue to be a mainstayin the anatomic Pathology B. Askin, of PathologyThe Johns Hopkins UniversitySchool of MedicineandDirector of Surgical PathologyThe Johns Hopkins HospitalBaltimore, MD 21231-2410, USAThis page intentionally left blank ixForeword to the First EditionThe modern Surgical Pathology cutting room is replete with tools of theelectronic age. Computers, automatic cassette labelers, bar coding, and evenelectronic voice-recognition systems are available to help the Surgical pathol-ogist be an effective, efficient, and highly productive cog in the machinery ofhealthcare delivery.