The tenth edition of Pathologic Basis of Disease we look to the future of pathology as a discipline and how this textbook can remain most useful to readers in the twenty-first century. It is obvious that an understanding
of disease mechanisms is based more than ever on a strong foundation of basic science. We have always woven the relevant basic cell and molecular biology into the sections on pathophysiology in various chapters. In the previous edition, we went one step further and introduced a new chapter at the very beginning of the book titled “The Cell as a Unit of Health and Disease.” We are delighted that the
chapter was found useful by many students and faculty. Because progress in basic cell biology is moving at a very brisk pace, the chapter has been updated significantly.
In the preface of the very first edition (1957), Stanley Robbins wrote:
“The pathologist is interested not only in the recognition of structural alterations, but also in their significance, i.e., the effects of these changes on cellular and tissue function and ultimately the effect of these changes on the patient. It is not a discipline isolated from the living patient, but rather a basic approach to a better understanding of disease and therefore a foundation of sound clinical medicine.”
We hope we continue to illustrate the principles of pathology that Dr. Robbins enunciated with such elegance and clarity over half a century ago.
This edition, like all previous ones, has been extensively revised, and some areas have been completely rewritten. A few examples of significant changes are as follows:
• Chapter 2 has been updated to include novel pathways of cell death beyond the long-established pathways of necrosis and apoptosis. Indeed, the distinction between these two is being blurred. Autophagy, which has begun to take center stage in diseases ranging from aging to cancer and neurodegeneration, has been revised, as have the possible molecular mechanisms of aging.
• In Chapter 3, we have married morphology with molecular mechanisms. Thus, different patterns of inflammation can be related to distinct molecular pathways.
• Chapter 5 includes a discussion of gene editing technology and a revised and updated section on molecular diagnosis.
• Chapter 7 has been extensively revised to incorporate new insights into cancer pathogenesis, the interplay between cancer cells and host immunity, and cancer precision diagnostics.
• Chapter 10, covering pediatric diseases, includes discussion of newly approved therapies targeting specific mutated forms of the CFTR transporter.
• Chapter 11, covering vascular diseases, includes discussion of clonal hematopoiesis, a newly emerging risk factor for atherosclerosis and other inflammatory disorders.
• Chapters 18 and 28, covering diseases of the liver and the central nervous system, have a fresh look brought in by new contributors.
• In addition to the revision and reorganization of the text, many new photographs and schematics have been added and a large number of the older “gems” have been enhanced by digital technology.
We made the changes highlighted above while remaining focused on the same longstanding overarching goals, which serve as our guiding principles:
• To integrate into the discussion of pathologic processes and disorders the newest established information available—morphologic as well as molecular.
• To organize information into logical and uniform presentations,facilitating readability, comprehension, and learning.
• To maintain the book at a reasonable size and yet provide adequate discussion of significant lesions, processes, and disorders. Indeed, despite the addition of new information, we are happy to state that the overall length of the book
is unchanged. One of our most challenging tasks is to decide what to eliminate to make room for key new findings.
• To place great emphasis on clarity of writing and proper use of language in the recognition that struggling to comprehend is time-consuming and wearisome and gets in the way of the learning process.
• To make this text useful to students throughout all of their years in medical school and into their residencies—but, at the same time, to provide sufficient detail and depth to meet the needs of more advanced readers.
We have repeatedly been told by readers that up-to-datedness is a special feature that makes this book very valuable. We have strived to remain current by providing new information from the recent literature, up to the current year, and by adding coverage of the COVID-19 epidemic.
All three of us have reviewed, critiqued, and edited each chapter to ensure the uniformity of style and flow that have been the hallmarks of the book. Together, we hope that we have succeeded in equipping the readers with the scientific
basis for the practice of medicine and in whetting their appetite for learning beyond what can be offered in any textbook.