Khare Pratima, Gupta Renu, Ahuja Mukta, Khare Nupur, Agarwal Swapnil, Bansal Deepti
Consultant and Head, Department of Pathology, Dr B.S.A. Hospital, New Delhi, India.
Senior Specialist, Department of Pathology, Dr B.S.A. Hospital, New Delhi, India.
J Clin Diagn Res. 2017 May;11(5):EC13-EC16. doi: 10.7860/JCDR/2017/24747.9827. Epub 2017 May 1.
Autopsies are carried out to establish the identity, cause of death, time of death, and ante-mortem or post-mortem nature of death. These help in establishing the cause of death and ascertain the disease process which led to death.
To study the prevalence and pattern of lung diseases in medicolegal autopsies, confirmed by histopathological examination.
This retrospective study was carried out in the Department of Pathology. Tissue bits from lungs, retrieved at the time of autopsy, were preserved in 10% formalin. These were processed and examined microscopically. A total of 86 cases were received during the period of study.
Among these 86 cases, in 4 cases (4.8%) the tissue was autolysed and in another 26 cases (30.1%) histopathology was unremarkable. Significant microscopic findings were found in 56 cases (65.1%). Wide spectrum of microscopic findings were seen, the commonest being oedema and congestion (28.5%) followed by changes in interstitium (11.9%). There were 9.5% cases of granulomatous inflammation and 5.9% cases each of acute pneumonia and emphysema. There were 1.2% cases each of Hyaline Membrane Disease (HMD), Meconium Aspiration Syndrome (MAS) and Acute Respiratory Distress Syndrome (ARDS) in the series. The series also had 1.2% cases of young adult having fungal colonies surrounded by necrosis and abscess formation. Possibility of mucormycosis was suggested in that case.
This study highlights various lesions in lungs confirmed by histopathology, which were either incidental or direct cause of death. The short coming in present study was non receipt of whole organ or representative sample at the time of autopsy, which if overcome will set much higher standard of autopsy reporting and would be a more useful tool in understanding cause of death.
进行尸检是为了确定身份、死亡原因、死亡时间以及死亡的生前或死后性质。这些有助于确定死亡原因并查明导致死亡的疾病过程。
研究经组织病理学检查确诊的法医学尸检中肺部疾病的患病率和模式。
本回顾性研究在病理科进行。尸检时获取的肺组织小块保存在10%福尔马林中。对这些组织进行处理并进行显微镜检查。研究期间共收到86例病例。
在这86例病例中，4例（4.8%）组织自溶，另外26例（30.1%）组织病理学检查无明显异常。56例（65.1%）发现有显著的显微镜下表现。观察到广泛的显微镜下表现，最常见的是水肿和充血（28.5%），其次是间质改变（11.9%）。有9.5%的病例出现肉芽肿性炎症，急性肺炎和肺气肿各占5.9%。该系列中有1.2%的病例为透明膜病（HMD）、胎粪吸入综合征（MAS）和急性呼吸窘迫综合征（ARDS）。该系列中还有1.2%的年轻成人病例，真菌菌落周围有坏死和脓肿形成。该病例提示可能为毛霉菌病。
本研究强调了经组织病理学证实的肺部各种病变，这些病变要么是偶然的，要么是死亡的直接原因。本研究的不足之处在于尸检时未收到整个器官或代表性样本，如果克服这一问题，将提高尸检报告的标准，并成为理解死亡原因更有用的工具。
