Rosai JUAN: Rosai and Ackerman's Surgical Pathology, 9th edn, in two volumes, 2977 pp, Edinburgh, Mosby, an imprint of Elsevier, 2004 ($349).

When Leonardo so famously said, ‘poor is the student who does not surpass his master’ he was probably not talking to students but was trying to alleviate the concerns of aging teachers. Along the same lines, I would like to assure the late Dr Ackerman: You may rest in peace wherever you are now sipping your favorite wine; even the most skeptic observers would admit that your star student Juan Rosai has surpassed you! In that process, he has also surpassed himself. By that I mean that he has produced a book that outshines all previous editions. He has also set the bar of excellence to a new and so far unattained height, proving beyond any reasonable doubt that he is not only the leading surgical pathologist of my generation but also a first class medical writer par excellence.

For me this is the third, and possibly the last time that I am writing about Dr Rosai's book. Thus, I hope that I will be forgiven for being occasionally a bit overenthusiastic. I should also add that I have not read my review of the previous edition, in which I already said that it was the best Surgical Pathology book in print. Hence, if some readers note occasional repetition, I hope that they will take it as a sign of my ‘consistency’ rather than a lack of inventiveness. In any case here are my seven reasons for liking the book so much.

First of all, this is a book for people who like pathology, who are curious by nature, and like to learn. If you belong to that group of pathologists, and if you know the previous editions, I am sure that you will enjoy Dr Rosai's didactic approach and the unique ackermanian spirit, that permeate the new edition the same ways as the previous ones. Everything is the same, but still it is not the same: large parts of the text have been rewritten, updated, and adapted to new times. The writing is crisp, the exposition masterful, and inspired. I also admired the style and the logic behind the well crafted sentences and succinctly assembled paragraphs that often read as mini-essays and have a distinct literary flavor. Many of the pieces I would call potentially anthological—exemplary writing of a truly great teacher and writer at his best!

Second, this is a single author's book, a type of book that is rapidly disappearing from the publishing scene. Dr Rosai, the leading pathologist of my generation, knows his pathology, so to say, and he can write about almost all aspects of surgical pathology. He is also an eager reader and has learned a lot of new things between the 8th and the 9th edition. Encyclopedic in his approach, he has an incredible command of facts, understands the various sides of the contentious arguments, and feels informed enough to voice his own views on a variety of topics. For chapters on the liver, kidney, bone marrow and neuropathology he has enlisted the help of trusted associates, who have followed his example and thus, the book still reads as a single author's work.

Third, this book reflects a life spent in surgical pathology—the author's experience and erudition but also his prejudices and doubts. Dr Rosai holds very strong opinions about many subjects and he is not shy of letting you know what he think about various issues. Reading the book you almost feel as you have received a consultation letter: this could be this and that.... I understand your reasoning and see you point... but in my opinion this lesion is this and that. One can learn not only how to gather and sort the facts but also how to interpret the macroscopic and microscopic and ancillary findings, how to reason, and how to arrive at the final diagnosis. A truly enlightening experience seeing a great analytic mind at work.

Fourth, the book has been illustrated with excellent, carefully chosen new color photographs—a major tour de force. These pictures are also available on two compact disks that transform the book into a ready source of illustrations for lectures, and a computer-compatible amphibian linking the era of Gutenberg with the era of silicon.

Fifth, the references are well chosen and informative, and up-to-date. As before the references are subdivided into subheadings corresponding to the subdivisions of the chapters. To this end, the author has repeated some key references several times in the same chapter. Personally, I would not have done it that way, but I also can understand the reasons for the approach that the author has chosen.

Sixth, the book is also a manual for the surgical pathology dissection room and contains instructions on how to process human organs and various tumor specimens. It also incorporates the checklists for reporting of major tumor types prepared by the College of American Pathologists. By following these instructions, the pathologist will be able to sample the surgical specimen in accordance with current practice, report the findings in a comprehensive synoptic manner, and also include the grading of the tumor.

Seventh, for all bibliophiles to note, the book is physically attractive and has been masterfully designed and produced.

Rosai and Ackerman's book is on the Brandon/Hill list, which guarantees that it will be purchased by many medical libraries. However, since it was written for practicing pathologists I am sure that many of them have already bought it or will probably buy it soon. For those practicing pathologist who have the 8th edition and are still wavering whether to buy the 9th edition or not, I have a rhetorical questions: How could you go wrong spending the cash you received for signing out 10 seborrheic keratoses for a book that took a master almost 10 years to produce?

While preparing for this review, I came across a note on the Web recommending Dr Rosai's book to practicing pathologists and reserving the multiauthored ‘competition’ for residents. As stated above, I agree with the first part of that recommendation. However, I also think that Rosai's book is ideal for learning surgical pathology; it is the Surgical Pathology book that I recommend to all my residents. I think that your residents should also buy it. Even though many of them already have access to a departmental copy, I would urge them to purchase a personal copy and ‘grow up on it’, annotate it, underline and abuse it ad libitum—in other words, take possession of it and identify with it for life. And may be even dream of surpassing the master one day, which of course brings me back to the beginning of this review.