Embryo and Fetal Pathology: Color Atlas with Ultrasound Correlation
by Enid Gilbert-Barness and Diane Debich-Spicer
Cambridge University Press, New York, 2004, $285
According to the authors of this book, the aim was to create a reference for a wide number of clinicians -- obstetricians, perinatologists, neonatologists, geneticists, and anatomic pathologists -- but not necessarily radiologists.
At first glance, Embryo and Fetal Pathology seems geared specifically toward the pathologist. It begins with an overview of gestational development, embryonic maldevelopment, and fetal and neonatal death. Next, fetal autopsy technique is reviewed, with multiple tables of organ weights and autopsy report templates included in the appendix.
But the subsequent chapter focuses on fetal ultrasound, broken down into sections of general sonographic principles, major organ system malformations, and advances in first trimester ultrasound, including 3D.
There are more than 200 ultrasound images scattered throughout the 711 pages, all correlated with pathologic findings. Several of the organ system-specific chapters finish with an ultrasound section.
The ultrasound and gross pathology images, combined with the excellent illustrations demonstrating the common anomalies, are a highlight of the cardiovascular chapter. In addition, a compilation of operative procedures for the correction of congenital heart disease features objectives, complications, and many diagrams.
Although the genitourinary system contains few radiologic images, the gross pathologic images of renal malformations and the reproductive tracts are excellent. The chapter ends with a normal range of ultrasound measurements of the kidneys during gestation. It also offers recommendations for following up certain findings that may lead to renal compromise; possibly require corrective surgery; or serve as markers for other anomalies.
Additional organ-system specific chapters include skeletal, respiratory, gastrointestinal, craniofacial, and the integument. There are also sections on congenital tumors, the placenta, the amnion, chromosomal abnormalities, dysplasias and syndromes, twins, and other selected topics.
The book is clearly written, concise, and filled with high quality, color examples of gross and microscopic pathology. The medical illustrations are exceptional. However, some of the ultrasound images are smaller than in most radiology texts.
Ultimately, the sonography sections alone are no substitute for a dedicated ultrasound text. Although radiologists may not have been part of the intended audience of Embryo and Fetal Pathology, the comprehensive text and the extensive radiologic-pathologic correlation can of value to the radiologist who practices fetal and pediatric imaging.
By Dr. Jonathan J. SudberryAuntMinnie.com contributing writer
October 13, 2004
Dr. Sudberry is a senior radiology resident at the University of Minnesota in Minneapolis.
The opinions expressed in this review are those of the author, and do not necessarily reflect the views of AuntMinnie.com.
Copyright © 2004 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
