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In the first edition of Textbook of Pathology with Clinical Applications published in 1957, Stanley Robbins M.D., the founding author of perhaps the best known of all pathology textbooks, stated:

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"Anyone who essays to predict the future of pathology tempts the fates. But it requires no prophet to appreciate that pathology stands on the threshold of great advances."

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His statement is just as true today. For Dr. Robbins those advances involved the ultrastructure of disease assayed by electron microscopy. Today we study the molecular structure of disease using genomics and proteomics. About tomorrow, who can say?

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Any textbook for medical students that attempts to provide an overview of pathology today must balance between the molecular nature of pathogenesis and well-established and clinically critical descriptions of the disease process at the organ, cellular, and ultrastructural levels. The balance is made more difficult by the fact that only a few percent of medical students will become pathologists. Those who do will use the traditional microscope as well as genomic and molecular tools to recognize and characterize disease. Even students who choose clinical and surgical specialties still must know the etiology and pathogenesis of the disorders they deal with in the setting of direct patient care and understand what the pathologist has to offer for that care.

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For these reasons, the choice of what to include in a text-book aimed at undergraduate medical students is always a compromise. However, the editor and authors of this work firmly believe that whatever the scope of information chosen, such information must be tied to the patient's condition to be meaningful to the student as well as exemplifying the clinical practice of pathology.

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Hence, we have centered our presentations around case studies designed to emphasize the role of the pathologist in the team that provides patient care, examining the role of anatomic, clinical, and molecular pathologists in that multi-membered group both in dedicated chapters and in descriptions of the pathology of specific organ systems. We have "tempted the fates" as did Dr Robbins by making predictions as to what areas of today's biomedical research might become tomorrow's standard of care.

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Howard M. Reisner

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