Endocrine glands – a case of antagonistic pleiotrophy

View Large Image | Download PowerPoint SlideEndocrine Pathology is a well compiled and comprehensive text of pathological changes in various endocrine organs. The basic premise of the book is that the normal function of endocrine organs – to synthesize and secrete hormones – comes at the cost of driving abnormal cell proliferation in an autocrine and/or paracrine manner that eventually presents as neoplasia. Although growth factors also act in an endocrine manner to drive tumor growth in other organs, the scope of Endocrine Pathology is restricted to endocrine organ pathology. It is hoped that future editions would include chapters on pathological changes in the mammary gland, prostate, uterus and other related structures. The book covers both traditional (pituitary, thyroid, parathyroid, adrenal and pancreas) and other endocrine (e.g. gastrointestinal tract, lung and skin) organ systems, and takes the reader through the normal histology and function of the gland to the pathological changes observed at the histological and electron microscopical levels.The book has been formatted well, providing a complete and logical characterization of all major endocrine organs. The text is supported by numerous informative color figures that clearly illustrate the pathological changes associated with each tissue and tables that summarize the frequency, prognosis and histological characteristics of different tumors. In addition, each chapter is well referenced, not only with regards to the basic science but also the information on pathological changes associated with each organ.The book begins by discussing the contribution of laboratory medicine to the diagnosis and management of endocrine tumors. The various competitive binding assays, such as radioimmunoassays, radioassays and receptor assays, used to measure hormone concentrations in serum and tissues are described, and issues surrounding the clinical application of such assays, including peptide hormone heterogeneity, autoantibodies and automation are identified. There is also a thorough examination of circulating markers for endocrine-related tumors.The following chapters discuss individual endocrine organs, beginning with background on the normal development and histology of the organs followed by a comprehensive listing of disorders for each organ and, in particular, the pathological changes leading to tumorigenesis. For example, the second chapter discusses dispersed neuroendocrine cells and their tumors throughout many tissues. The next chapter provides an in-depth discussion of the histology of the pituitary gland and the pathological and clinical manifestations of pituitary disorders, including congenital and developmental disorders, cystic lesions, inflammatory disorders, hyperplasia and tumors, in particular the numerous adenomas that form in each of the cell types of the gland. Also included is a description of tumors of the hypophysis and hypothalamus. This chapter is typical of the way the book is structured, moving through the different endocrine organs of the body: thyroid, parathyroid and adrenal glands, endocrine glands associated with digestive tract and lesions of the skin, finishing with reproductive organ pathologies, including a discussion of placental changes in complicated pregnancies. A summary chapter drawing together commonalities from each of the chapters would round off the book. Nonetheless, the absence of such a summary does not seriously detract from the book as a whole.Overall, I recommend this well-overdue book to clinical pathologists as a rich source of information on endocrine organ disease. Endocrine Pathology should also serve as a valuable resource for researchers eager to advance their knowledge of endocrine diseases.