Reviewer: Mario Mosunjac, M.D(Emory University School of Medicine)
Description: The Forensic Pathology Reviews, Volume 2, by Dr. Michael Tsokos from the Institute of Legal Medicine, University of Hamburg, Germany, is a second volume in series of forensic pathology reviews and represents a multifaceted and interdisciplinary review of specific and unusual entities encountered in daily practice of forensic medicine.
Purpose: Purpose of this book is to serve as a supplemental reading in forensic pathology field. Chapters in this book reflect very diverse topics in day-to-day practice of the forensic pathologist, and are mostly independent, in-depth analysis of very specific diseases and unusual human behavior. A comprehensive approach to relatively obscure entities within the medical field is supported by an extensive literature review. Series of the books such as Forensic Pathology Reviews represent an excellent and original idea to cover some of the forensic pathology issues, often overlooked in classical textbooks.
Audience: The book is primarily intended to serve as a practical guide to forensic and hospital-based autopsy pathologists, residents in forensic and pathology training, medical students and other branches within the University setting, interested in research and multidisciplinary collaboration. Residents in pathology and forensic pathology training and pathologists will appreciate plethora of gross images of the external injuries inflicted by specific objects, seldom seen in other major forensic pathology books. In addition, there are innumerable tables in chapters such as Obesity Epidemic in the United States, emphasizing broader epidemiological aspect of this important topic. This book can also serve as an important guide to residents in their preparation for weekly autopsy conferences, by summarizing mechanisms and causes of sudden and unexpected death associated with some rare entities. Investigators, anthropologists, forensic odontologists and toxicology divisions within a large State Medical Examiner's offices in the United States, will find chapters such as practical toxicology, arthropods and corpses very useful in preparation for scene investigation and case analysis.
Features: The Forensic Pathology Reviews is divided into 13 independent chapters. The first chapter describes complex metabolic stages in pathogenesis of cachexia and associated clinical and gross autopsy findings. This chapter, supported by numerous tables, photos of the scene of death, author's personal case material and cases reported in literature, represents and important attempt to create a uniform approach to investigation of life threatening conditions such as starvation. In his second chapter, the author is describing specific blunt force injuries of the skull inflicted by blows with glass bottles. In doing so, Dr. Tsokos tried to establish more specific "pattern" injuries inflicted by such object. The text is accompanied by large number of gross autopsy images, with detailed explanation, reiterating some of the most common injury patterns. Importance of this approach is to separate other blunt force injuries mimicking lacerations inflicted by glass bottles. One of my favorite chapters was "Primary Cerebral Neoplasms as a Cause of Sudden, Unexpected Death". The author's summary of the most common primary brain neoplasms and mechanisms of sudden death with short overview of tumor epidemiology, correlates perfectly well in number of cases and types of neoplasms with my own experience. The importance of this chapter is in proposing the guidelines and algorithm for cases of sudden death associated with brain tumors, especially in institutions where a neuropathologist is not readily available for consultation. The fifth chapter helps us to understand the types of asphyxial deaths in infants and early childhood. This topic is supported by a number of excellent scene photos; external and internal gross autopsy findings and associated microscopic images of the lung tissues. In his final pages, the author describes, in detail, asphyxial deaths from mechanical suffocation such as overlaying and wedging, and difficulties in distinguishing these cases from SIDS (sudden infant death syndrome) fatalities. An overview of complex suicide cases emphasizes an important aspect of every day practice, in which forensic pathologist should be able to differentiate these complex cases from homicides. The chapter on "Sudden, Unexpected Death Related to Viral Myocarditis" brings a new, refreshing and the most extensive review of myocarditis. It contains numerous gross photos, conventional histopathology images, and review of immunohistochemical ancillary techniques and molecular methods. The importance of this chapter should be also seen in the review of classic viral pathogens, Dallas criteria of myocarditis, and pathogenic mechanisms of sudden death associated with viral myocarditis. A significant discussion on tissue sampling, and the significance of focal mononuclear infiltrate is also provided. The chapter on "Forensic Entomology, Arthropods and Corpses" is an extensive overview of entomology topics including historical perspective, scene investigation, estimation of time of death, collection of arthropods, and even DNA typing. The practical toxicology chapter is an outstanding review of illicit drugs and their metabolites, which emphasized the significance of proper tissue and body fluids sampling. In these pages one can encounter a variety of topics, from metabolism and detection of common intoxicants, to more unusual "Date Rape" drugs and inhalants. The pitfalls of toxicology testing and interpretation are addressed as well as the need for close collaboration between pathologist and forensic toxicology laboratory. "Long -Term Effects of Anabolic-Androgenic-Steroid Abuse" is becoming more important not only in the sphere of professional, but also amongst the amateur athletes. In this chapter, major pathological findings associated with sudden death in people abusing anabolics are discussed. These findings are supported with number of microscopic images of the affected organs. In addition, the last chapter, 13, describes in details one of the "borderline" entities such as autopsy findings of subendocardial hemorrhage. The significance of the fresh subendocardial hemorrhages often encountered in forensic and hospital-based autopsies is not clear, and is often controversial. The author's brave attempt to summarize and propose mechanisms and disease processes associated with this morphological finding, is supported with number of gross, microscopic images and quite extensive literature review.
Assessment: This book series represents an excellent resource and supplement to the major textbook in forensic pathology, and can serve as a practical guide to forensic and autopsy pathologists. Independent chapters that approach some of the controversial topics are very extensive, interdisciplinary and can be used as a source for an additional reading and consultation for everybody involved in postmortem examination.