Chapman R C, Claydon S M
Department of Forensic Medicine and Toxicology, Charing Cross and Westminster Medical School, London.
J Clin Pathol. 1992 Aug;45(8):713-5. doi: 10.1136/jcp.45.8.713.
To describe the pathological and background features of several cases of tuberculosis diagnosed at post mortem examinations and performed on behalf of HM Coroner over a three year period in west London.
Postmortem examinations were carried out by two pathologists working at hospital and public mortuaries in west London. Cases of tuberculosis were provisionally diagnosed on gross examination and the diagnosis confirmed on haematoxylin and eosin and Ziehl-Neelsen staining of retained tissues. The background information was obtained by scrutinising hospital records and by direct enquiry to general practitioners by coroners' officers.
Thirteen cases of pulmonary tuberculosis were diagnosed during the period. No other cause of death was found. The incidence of fatal pulmonary tuberculosis was 0.28% of coroners' necropsies in the study region. Cases had been referred to the coroner because death had occurred unexpectedly, or because no recent medical attention had been sought. Most cases arose among the elderly Asian immigrant population or the homeless or the alcoholic, or both. In 10 cases the macroscopic findings strongly indicated pulmonary tuberculosis and in the other three the diagnosis was considered to be a differential diagnosis.
These findings have important health implications for those carrying out post mortem examinations from these groups as well as for those involved with the continuing care of immigrant or vagrant populations.
描述在伦敦西部代表HM验尸官进行的三年尸检中诊断出的几例肺结核病例的病理及背景特征。
尸检由伦敦西部医院和公共停尸房的两名病理学家进行。肺结核病例通过大体检查初步诊断，并通过对留存组织进行苏木精-伊红染色和齐-尼氏染色来确诊。背景信息通过查阅医院记录以及验尸官办公室直接向全科医生询问获取。
在此期间诊断出13例肺结核病例。未发现其他死因。研究区域内致命性肺结核的发病率占验尸官尸检的0.28%。病例被提交给验尸官是因为死亡意外发生，或者因为近期未寻求医疗救治。大多数病例出现在老年亚洲移民群体、无家可归者或酗酒者中，或两者兼有。10例病例的宏观检查结果强烈提示为肺结核，另外3例的诊断被认为是鉴别诊断。
这些发现对参与这些群体尸检的人员以及参与移民或流浪人群持续护理的人员具有重要的健康意义。
