Difference between revisions of "Lung autopsy"
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==Microscopic evaluation== | ==Microscopic evaluation== | ||
− | [[File:Histopathology of pulmonary congestion and siderophages.jpg|thumb|220px|'''Siderophages''' (one indicated by white arrow), indicating chronic left heart failure. Also pulmonary '''congestion''' and '''lymphocytes''', consistent with heart failure.]] | + | [[File:Histopathology of pulmonary congestion and siderophages.jpg|thumb|220px|'''Siderophages'''{{Siderophage note 1}} (one indicated by white arrow), indicating chronic left heart failure. Also pulmonary '''congestion''' and '''lymphocytes''', consistent with heart failure.]] |
Look for the most common pathologic lung findings:<ref name="TiwanaNibhoria2014">'''India''': {{cite journal|last1=Tiwana|first1=Kanwardeep Kaur|last2=Nibhoria|first2=Sarita|last3=Gupta|first3=Manvi|last4=Yadav|first4=Ashish|title=Histopathological Spectrum in Lung Autopsies- A 50 Case Study|journal=Indian Journal of Forensic Medicine & Toxicology|volume=8|issue=2|year=2014|pages=172|issn=0973-9122|doi=10.5958/0973-9130.2014.00709.9}}</ref><ref>'''United States''': {{cite web|url=https://washingtonforensicsservices.com/pulmonary-lung-conditions-found-at-autopsy/|title=Pulmonary Lung Conditions Found at Autopsy|author=Dr. Stanley Adams|website=Washington Forensic Services|accessdate=2019-12-20}}</ref> | Look for the most common pathologic lung findings:<ref name="TiwanaNibhoria2014">'''India''': {{cite journal|last1=Tiwana|first1=Kanwardeep Kaur|last2=Nibhoria|first2=Sarita|last3=Gupta|first3=Manvi|last4=Yadav|first4=Ashish|title=Histopathological Spectrum in Lung Autopsies- A 50 Case Study|journal=Indian Journal of Forensic Medicine & Toxicology|volume=8|issue=2|year=2014|pages=172|issn=0973-9122|doi=10.5958/0973-9130.2014.00709.9}}</ref><ref>'''United States''': {{cite web|url=https://washingtonforensicsservices.com/pulmonary-lung-conditions-found-at-autopsy/|title=Pulmonary Lung Conditions Found at Autopsy|author=Dr. Stanley Adams|website=Washington Forensic Services|accessdate=2019-12-20}}</ref> | ||
*'''Edema and congestion''' (often together), indicating left sided heart failure: | *'''Edema and congestion''' (often together), indicating left sided heart failure: | ||
:*'''Acute''' congestion manifests as alveolar capillaries being engorged with blood, as well as associated alveolar septal edema and/or focal intra-alveolar hemorrhage.<ref name=humpath>{{cite web|url=http://humpath.com/spip.php?article7894|title=Congestion|website=Humpath|date=2005-12-19}}</ref> | :*'''Acute''' congestion manifests as alveolar capillaries being engorged with blood, as well as associated alveolar septal edema and/or focal intra-alveolar hemorrhage.<ref name=humpath>{{cite web|url=http://humpath.com/spip.php?article7894|title=Congestion|website=Humpath|date=2005-12-19}}</ref> | ||
− | :*'''Chronic''' congestion manifests as thickened and fibrotic septa, and alveolar spaces containing numerous siderophages.<ref name=humpath/> | + | :*'''Chronic''' congestion manifests as thickened and fibrotic septa, and alveolar spaces containing numerous siderophages{{Siderophage note 2}}.<ref name=humpath/> |
*'''Pneumonia''': Inflammatory cells | *'''Pneumonia''': Inflammatory cells | ||
*'''Tuberculosis''' in regions of the world with substantial prevalence | *'''Tuberculosis''' in regions of the world with substantial prevalence |
Revision as of 12:05, 30 January 2020
Author:
Mikael Häggström [note 1]
Not including larger pulmonary vessels (instead summarized at Autopsy - Other thorax).
Contents
Basic autopsy cutting
In non-forensic Autopsy:
- Dissect the pulmonary arterial system, from the pulmonary trunk and including at least segmental arteries.
- Dissect the bronchial tree, at least to segmental bronchi. Check for obstructions.
- Make some additional sections through the lung parenchyma. Squeeze at each side to detect any pus and edema.[1]
Further information: Autopsy
Gross evaluation
- A spongy consistency, and watery and frothy liquid being pressed from the parenchyma, indicates simple edema.[2]
- A spongy consistency and reddish (blood-stained) fluid being pressed from the parenchyma, indicates acute congestion.[2]
- A brownish or dark reddish color of the fluid pressed from the parenchyma indicates chronic congestion, and may not have a spongy consistency.[2]
Fixation
Generally 10% neutral buffered formalin.
See also: General notes on fixation
Microscopic evaluation
Look for the most common pathologic lung findings:[3][4]
- Edema and congestion (often together), indicating left sided heart failure:
- Pneumonia: Inflammatory cells
- Tuberculosis in regions of the world with substantial prevalence
- Carcinoma
- Aspiration: Other foreign contents in airways. Further information: Aspiration in autopsy
Reporting
Report findings and if they are consistent with already known diagnoses. Further information: Autopsy
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Burton, Julian L.; Rutty, Guy N. (2010). The Hospital Autopsy A Manual of Fundamental Autopsy Practice (3rd ed.). Oxford University Press. ISBN 978-0340965146.
- ↑ 2.0 2.1 2.2 page 62 in: J. Martin Beattie (2014). Post-Mortem Methods . Cambridge University Press. ISBN 9781107418004.
- ↑ India: Tiwana, Kanwardeep Kaur; Nibhoria, Sarita; Gupta, Manvi; Yadav, Ashish (2014). "Histopathological Spectrum in Lung Autopsies- A 50 Case Study ". Indian Journal of Forensic Medicine & Toxicology 8 (2): 172. doi: . ISSN 0973-9122.
- ↑ United States: Dr. Stanley Adams. Pulmonary Lung Conditions Found at Autopsy. Washington Forensic Services. Retrieved on 2019-12-20.
- ↑ 5.0 5.1 . Congestion. Humpath (2005-12-19).
Image sources