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During most of the nineteenth century, the discipline of pathology in Boston made substantial strides as a result of physicians and surgeons who practiced pathology on a part-time basis. The present essay tells the subsequent story, beginning in 1892, when full-time pathologists begin to staff the medical schools and hospitals of Boston. Three individuals from this era deserve special mention: William T Councilman, Frank Burr Mallory and James Homer Wright, with Councilman remembered primarily as a visionary and teacher, Mallory as a trainer of many pathologists, and Wright as a scientist. Together with S Burt Wolbach in the early-to-mid-twentieth century, these pathologists went on to train the next generation of pathologists-a generation that then populated the various hospitals that were developed in Boston in the early 1900s. This group of seminal pathologists in turn formed the diagnostically strong, academically productive, pathology departments that grew in Boston over the remainder of the twentieth century.

The venerable tradition of British gynaecological pathology is honoured by brief comments on those who have pioneered work in this arena, using as the starting point the remarkable Scottish physician Dr Matthew Baillie who, with his uncles, the legendary William and John Hunter, can arguably be considered the founders of medicine in Great Britain. The impact of Baillie's great work 'The Morbid Anatomy of Some of the Most Important Parts of the Human Body' is noted. Because of the fame they achieved in working in other areas, the contributions to gynaecological pathology of Thomas Hodgkin and Richard Bright, particularly the former, are often overlooked and are noted herein as is a remarkable book on the ovary by Charles G. Ritchie, published in 1865. The middle years of the 19th century were notable because of the activities of pioneering surgeons such as Sir Spencer Wells and Lawson Tait which gradually led to a greater emphasis on pathologic examination of specimens removed at operation, as opposed to autopsy evaluation. The closing years of the 19th century and early years of the 20th century were dominated by five individuals, Alban Doran, John Bland-Sutton, Cuthbert Lockyer, Elizabeth Hurdon and John Hammond Teacher. Doran wrote an early study of tubal carcinoma and a book on that organ and the ovary. Bland-Sutton was a remarkably influential surgeon with a significant interest in pathology and also contributed a book on the ovary and fallopian tube as well as one of the early good papers on metastatic tumours to the ovary. Lockyer wrote an outstanding book on uterine fibroids and established, and funded, a museum at Charing Cross Hospital. Hurdon can be considered the first female gynaecological pathologist. She spent much of her active career in the United States working at Johns Hopkins Hospital. She co-authored a monumental book on the appendix, likely never to be equalled. Teacher worked in Glasgow for many years and was almost single-handedly responsible for the acceptance in Britain of the concepts of trophoblastic disease espoused by the German investigator Felix Marchand. Wallace Park of Dundee also contributed significantly on trophoblastic disease in later years. The years following the death of Dr Teacher were largely dominated by three individuals, Magnus Haines working in London, Claud Taylor in Birmingham, and Frederick Langley in Manchester. The first two individuals wrote an excellent textbook and Langley brought great fame to the Manchester School, ably assisted by Harold Fox, the latter being the doyen of British gynaecologic pathologists throughout the latter decades of the 20th century. With Langley he wrote an important book on ovarian tumours, an equally influential book on the placenta, and with Dr Hilary Buckley he authored a book on endometrial biopsy interpretation. Additionally, his countless entertaining and instructive lectures throughout the world represented a remarkable educational experience.

The histopathology of testicular tumors is presented, emphasizing new, unusual, or underemphasized aspects. Within the category of seminoma of the usual type, the recent literature has drawn attention to the presence in occasional tumors of solid or hollow tubules or spaces of varying sizes and shape that may result in cribriform or microcystic patterns, causing potential confusion with other neoplasms, most notably Sertoli cell tumor or yolk sac tumor. Although regions of typical neoplasia and awareness of this phenomenon usually will be diagnostic, immunohistochemistry may play a role in excluding Sertoli cell tumor or yolk sac tumor. Although immunohistochemistry can play an undoubted helpful role in this and selected other areas of testicular tumor evaluation, careful evaluation of the gross and routine microscopic features will solve the vast majority of diagnostic problems. An excellent review of immunohistochemistry in this area by R. E. Emerson, MD, and T. M. Ulbright, MD, is cited herein. Spermatocytic seminoma remains a crucial pitfall in diagnosis, and the pathologist must always be alert to the possible diagnosis when looking at a seminomatous neoplasm, particularly in an older patient, although about one third of these tumors occur in the usual seminoma age range. The embryonal carcinoma has a great diversity of patterns, which are briefly noted. The enigmatic and picturesque tumor, polyembryoma, which virtually never occurs in pure form but may be a confusing component of a variety of mixed germ cell tumors, is discussed and illustrated. The phenomenon of burnt-out germ cell neoplasia is also briefly noted and an excellent recent contribution is referred to. Within the sex cord-stromal family of neoplasms, recent contributions and elaborations of unusual morphologic features of Leydig cell tumors and Sertoli cell tumors are presented. Within the Leydig cell family, cyst formation, adipose metaplasia, calcification or ossification, and spindle cell patterns may be particularly confusing, and in the Sertoli cell family, a great array of patterns caused by differing admixtures of tubular, solid, and stromal components occur. The peculiar lesion, intratubular large cell hyalinizing Sertoli cell tumor, of young boys with Peutz-Jeghers syndrome, is briefly discussed. Some of the problems in the family of hematopoietic neoplasms are reviewed, these processes posing diverse problems in differential diagnosis and their correct recognition having crucial therapeutic implications. Although secondary tumors to the testis have not received the same attention in the literature as the similar phenomenon in the female gonad, remarkable examples of testicular spread of diverse neoplasms, usually carcinoma but rarely melanoma, are seen, and the pathologist should be alert to this possibility, particularly when examining an unusual morphology in an older patient. Finally, a few comments are made on the common paratesticular neoplasm, the adenomatoid tumor, highlighting its varied patterns and recent description of some of the issues that may arise when they undergo total or subtotal infarction.

Our understanding of gonadal pathology has reached its current state as a result of the contributions of numerous outstanding investigators. Knowledge of testicular tumor pathology dates back to the great British workers Percival Pott and Sir Astley Cooper but the single greatest early stride was made with the description in 1906 by the French urologist Maurice Chevassu of the seminoma. The seminal 1946 paper of Nathan B Friedman and Robert A Moore, which segregated out as a distinct entity embryonal carcinoma, is, however, the foundation for the current classification of testicular tumors. In that year Pierre Masson described the distinctive neoplasm, the spermatocytic seminoma. The 1950s saw the publication of an important paper by Frank J Dixon and Dr Moore and they also wrote the first series fascicle on testicular tumors. In this same timeframe, and thereafter, Robert E Scully made significant contributions to testicular pathology, writing the first English language paper on spermatocytic seminoma, describing several subtypes of sex cord tumor, and also the distinctive lesion of intersex, the gonadoblastoma, as well as playing a major role in 1980 in formulating the current classification of premalignant lesions of the testis. The current classification of testicular tumors was arrived at in the early 1970s when the World Health Organization, under the leadership of Dr FK Mostofi, who himself made notable contributions to testicular pathology, devised what is fundamentally the current classification of neoplasms of the male gonad. Although comments on ovarian pathology were made by such legendary figures of earlier times as Giovanni Battista Morgagni and Matthew Baillie, it is only in the mid to later years of the 19th century that contributions, mostly in Europe, began to move knowledge of ovarian pathology to its current state. Thomas Hodgkin, Richard Bright, and Sir James Paget all wrote extensively on ovarian neoplasms. In 1870, Heinrich Waldeyer, and later in that century, another German, Hermann Johannes Pfannenstiel wrote important papers on the surface epithelial tumors. The latter was likely the first to refer to neoplasms now known as of 'borderline malignancy' and also wrote on pseudomyxoma peritonei and other topics. Their work was followed by that of Robert Meyer who made monumental contributions to gynecological pathology, including recognizing the Brenner tumor as a distinctive neoplasm and proposing the first classification of Sertoli-Leydig cell tumors (arrhenoblastomas). He also coined the term 'disgerminoma' (soon changed to dysgerminoma) for the ovarian tumor that had been described in detail by the French investigator Marcel Chenot 5 years after Chevassu had mentioned the tumor in his paper describing the seminoma. During the Meyer era other significant contributions were made by, among others, Howard C Taylor writing on the borderline tumors and John A Sampson writing on endometriosis and tumors, associated with it. In the second-half of the 20th century major contributions were made by Gunnar Teilum of Denmark and Lars Santesson of Sweden. Dr Teilum delineated the morphologic features of the yolk sac tumor and noted the resemblance of papillary formations within it to the endodermal sinuses of the rat placenta. He also wrote extensively on sex cord tumors in both gonads. At a FIGO meeting in 1961 Dr Santesson played a major role in formulating the first organized classification of the surface epithelial-stromal tumors of the ovary and also promoted the endometrioid carcinoma as a special variant of ovarian cancer. In a career spanning over 50 years, Dr Scully was the architect of the modern classification of ovarian tumors being the driving force behind the influential 1973 World Health Organization classification of them. His many original observations have touched upon virtually all categories of ovarian tumor pathology. His second series fascicle 'Tumors of the Ovaries and Maldeveloped Gonads' utilized the WHO classification and presented a lucid elaboration of his by then vast experience with ovarian tumors. All the above have left a rich legacy which those who follow in their path will be challenged to equal.

Selected outstanding books from the older literature on gynecologic pathology are reviewed with emphasis on drawing attention to the abundant helpful information and often outstanding illustrations that are worthy of review by present-day pathologists. This represents a follow up to a previous similar essay that appeared in Volume 19:67-84, 2000. The first three books cover general gynecological pathology: Gynecological Pathology by Carl Abel; Gynecological and Obstetrical Pathology by Robert T. Frank; and Haines and Taylor's Gynaecological Pathology by Magnus Haines and Claud W. Taylor. Each of them emphasizes the time-honored problem of mimicry of malignancy by diverse benign lesions or even aspects of normal histology. Awareness of the clinical background and cooperation between the clinician and pathologist are emphasized. The other three books considered are all devoted largely or exclusively to the ovary: Ovarian Tumors by Hans Selye, Ovarian Neoplasms, Morphology, and Classification by Karel Motlik, and Special Tumors of Ovary and Testis and Related Extragonadal Lesions by Gunnar Teilum. The book of Selye has a truly remarkable encyclopedic coverage of the older literature, the references being so comprehensive that they are presented in a separate volume. A number of aspects of the histopathology of ovarian tumors that have been emphasized in recent years are noted in Selye's book. Dr. Motlik's book presents a very high quality consideration of the differential diagnosis of ovarian tumors. Teilum's book contains a masterful account of the histopathology of germ cell tumors emphasizing a neoplasm with which his name will always be associated, the yolk sac tumor (endodermal sinus tumor). Numerous beautiful and refreshingly large illustrations are provided, and Dr. Teilum's interest in comparative pathology is evident in the pages, his linking of the famous Schiller-Duval bodies with the endodermal sinuses of the rat placenta, being the most notable example.

James Homer Wright (1869-1928), the eldest son of a Pittsburgh glass merchant, was educated in Baltimore and practiced pathology in Boston from 1893 until his death in 1928. In 1896, when not quite 27 years old, he assumed directorship of the newly founded Pathology Laboratory at the Massachusetts General Hospital, a post he held for the next 30 years. He is remembered eponymously by the blood cell stain that bears his name and the Homer Wright pseudorosettes of neuroblastoma, but he made many additional contributions to pathology. These include the following: determination of the cellular lineage of multiple myeloma, identification of the megakaryocyte as the cell of origin of blood platelets, recognition of the cell of origin of the neuroblastoma, demonstration of spirochetes in syphilitic aneurysms of the aorta, and clarification of misconceptions about actinomycosis. Additionally, Wright coauthored, with Dr. Frank B. Mallory, the book Pathological Technique, which was a staple of laboratories for >40 years and exemplifies Wright's wide-ranging interests in, and contributions to, practical aspects of pathology including staining, culture and frozen section techniques, photography, and development of the rotary microtome. He received Honorary Doctor of Science Degrees from Harvard University, the University of Maryland (his alma mater), and the University of Missouri. He was the recipient of the Gross prize in 1905 for his publication on actinomycosis and the Boylston Medical Prize in 1908 for his discovery of the origin of platelets, and he was inducted into the American Academy of Arts and Sciences in 1915. Although shy and somewhat austere in the workplace, a different side was shown by his anonymously sending flowers to a young Norwegian opera singer whom he subsequently married. The pathology laboratories of the Massachusetts General Hospital were named the "James Homer Wright Pathology Laboratories" in 1956. Today James Homer Wright is remembered and honored 100 years after his description of the stain that, along with the pseudorosettes of neuroblastoma, carry his name into eternity and ensure his great contributions will never be forgotten.

James Homer Wright is a distinguished figure in the history of pathology and one of the founders of the discipline in the hospitals of Harvard Medical School. While he has been recognized as a highly accomplished investigative pathologist, historical sources have described him as austere, formidable, forbidding, disheartening, and gruff. Wright once did something seemingly so impulsive that it astonished his colleagues. When he heard a beautiful Norwegian contralto named Aagot Lunde perform, he anonymously sent her roses on a daily basis until she eventually agreed to meet him. They fell in love, married, and lived happily together until Aagot's death. This article paper explores the lives and careers of J. Homer Wright and Aagot Lunde Wright using unique archival materials as well as newspaper and magazine coverage of their life and travels together. After their marriage, Aagot soon stopped performing, but Mrs. Wright continued as a New England socialite for about a decade, which also coincided with the timeframe in which J. Homer made almost all of his important discoveries. James Homer Wright was covertly a romantic who thrived academically when supported by his wife, both of their families, and close friends. [ABSTRACT FROM AUTHOR]

Discusses several sources for collecting classic pathology textbooks. Book publishers; Web sites.