REVIEWS OF BOOKS I I I

The Chest Film in Massive Pulmonary Embolism. By DANIEL J. TORRANCE, JR. Springfield, Illinois: Charles C. Thomas. 1963. Pp. 74. $6-75.

In this monograph a short description of the clinical and pathological features of massive pulmonary embolism is followed by illustrations of the usual morphology of the pulmonary arteries and the changes which Occur in massive embolism. The radiological findings on plain films are then discussed in more detail, but no new facts are added to the previous literature on this subject and the inclusion of only six references is disappointing. The valuable part of the book is the recording of the plain films of 23 confirmed cases of massive pul- monary embolism, associated with line drawings depicting the pathology. In many of these cases films taken before embolism and follow-up films after it are also reproduced, as well as some tomograms and angiograms. The great majority of these illustrations are of excellent quality, and the good correlation between the plain film findings, the subsequent investigations and the patho- logy is emphasized.

Now that pulmonary angiography and radioisotope scanning are being used in more centres to confirm clinical diagnoses of pulmonary embolism, the value of good portable chest films, which in many cases give all the information neces- sary for emergency treatment, including surgery if indicated, needs to be stressed.

This monograph is recommended to anyone unfamiliar with its features. The book is attractively bound and well set out, but $6.75 is perhaps slightly expensive for its limited content.

J. KENDALL.

Anleitung zur praktischen Zytodiagnostik des Lungenkrebses. By SIEGFRIED ZIMMER. Leipzig: VEB Georg Thieme. 1965. Pp. 171. MDN 43.2O.

Dr. Zimmer believes that the cytological examination of sputum has a great contribution to make to the early diagnosis of lung cancer, and he urges its wider use as a screening technique, among his recommendations being a six- monthly sputum check for all patients with chronic bronchitis. His technical approach is quite different from that current in the West. He begins by exam- ining several portions from each specimen under phase contrast. Then he makes acridine orange, Papanicolaou, and May-Grtinwald-Giemsa prepara- tions in every case. But he does not commit himself until he has studied sections cut from the centrifuged deposit by Kahlau's technique.

His descriptions of neoplastic ceils in sputum betray some lack of personal experience, and in this section, as indeed throughout the book, he displays a slavish and uncritical reliance on the literature.

In four years he examined some 2,ooo sputa from 1,565 patients, in 418 of whom the diagnosis of bronchial carcinoma was subsequently confirmed. He identified neoplastic cells in no less than 94"4 per cent. of these 418 patients, but this extremely high detection rate was marred by I I.O per cent. of false positive findings in the 1,147 patients without cancer. This colossal false- positive rate he ascribes to basal cell hyperplasia and squamous metaplasia of the epithelium, remarking that it is one of the teething troubles of the cytologist and will become gradually less frequent as he gains experience.

D. WINSTANLEY.