Administrators, Editors, Image-reviewer, Moderators (CommentStreams), Interface administrators, Administrators, Upload Wizard campaign editors
7,044
edits
Changes
Jump to navigation
Jump to search
[[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 acute or chronic heart failure.]]
→Gross evaluation: Templated
! !! Left !! Right
|-
! Men<ref name="MolinaDiMaio2012">{{cite journal|last1=Molina|first1=D. Kimberley|last2=DiMaio|first2=Vincent J.M.|title=Normal Organ Weights in Men|journal=The American Journal of Forensic Medicine and Pathology|volume=33|issue=4|year=2012|pages=368–372|issn=0195-7910|doi=10.1097/PAF.0b013e31823d29adMolinaDiMaio2012}}</ref>
| 112-675g || 155-720g
|-
! Women<ref name="MolinaDiMaio2015">{{cite journal|last1=Molina|first1=D. Kimberley|last2=DiMaio|first2=Vincent J. M.|title=Normal Organ Weights in Women|journal=The American Journal of Forensic Medicine and Pathology|volume=36|issue=3|year=2015|pages=182–187|issn=0195-7910|doi=10.1097/PAF.0000000000000175MolinaDiMaio2015}}</ref>
| 105-515g || 101-589g
|}
==Microscopic evaluation==
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>
*'''[[Alveolar fluid]]'''. {{further|Alveolar fluid|linebreak=no}}
*'''Vascular congestion''', which can usually be seen easiest in the alveolar walls. It indicates left sided heart failure, especially when seen together with [[alveolar fluid]].{{further|Chronic pulmonary congestion|linebreak=no}}*'''Inflammatory''' cells, where a mild to moderate lymphocytic infiltrate is consistent with with heart failure, while neutrophils indicate pneumonia. '''[[pigmented macrophages of the lung]]''' may indicate chronic heart failure.
*'''Mycobacteria''' in regions of the world with substantial prevalence
*'''Carcinoma''' {{further|Lung tumor|linebreak=no}}
*'''Aspiration''': Other foreign contents in airways. {{Further|Aspiration in autopsy}}
*'''Embolism''' of pulmonary arteries.
<gallery mode=packed heights=190>
File:Histopathology of pulmonary edema.jpg|'''Edema'''
File:Histopathology of bronchopneumonia.jpg|'''Bronchopneumonia''', with neutrophils filling a bronchiole.
File:Bronchioloalveolar Cell Adenocarcinoma of the Lung (4669552489).jpg|'''Carcinoma''' (in this case bronchioloalveolar cell adenocarcinoma) {{further|Lung tumor|linebreak=no}}
File:Histopathology of diffuse alveolar damage.jpg|'''hyaline membranes''', suggesting '''diffuse alveolar damage'''.
File:Histopathology of a pulmonary artery with fat embolism and a bone marrow fragment.jpg|A pulmonary artery with fat embolism (seen as multiple empty globular spaces on this H&E stain since its processing dissolves fat). There is a bone marrow fragment in the middle, and multiple single hematopoietic cells in the blood, being evidence of fracture as the source of the embolism.
</gallery>
*'''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>
:*[[Chronic pulmonary congestion|'''Chronic''' pulmonary congestion ]] manifests as thickened and fibrotic septa, and alveolar spaces containing numerous siderophages{{Siderophage note 2}}'''[[pigmented lung macrophages]]'''.<ref name=humpath/>
[[File:Histopathology of respiratory epithelial shedding.jpg|thumb|center|290px|If respiratory '''epithelial shedding''' is seen, look for vascular leakage, mucus hypersecretion and/or widespread airway narrowing, together indicating asthma death.<ref>{{cite book | last=Madea | first=B | title=Handbook of forensic medicine | publisher=Wiley-Blackwell | publication-place=Hoboken, N.J | year=2014 | isbn=978-1-118-57062-3 | oclc=872114659 | ref=harv}}</ref> Otherwise, it is a frequent postmortem change.]]
Example:
{|class="wikitable"
| [[File:Histopathology of pulmonary congestion and siderophages.jpg|190px|left]] Presence of sideophages [[sideophage]]s indicating chronic heart failure. Prominent vessels, including alveolar capillaries, and a moderate lymphocytic infiltrate, consistent with chronic heart failure or acute decompensation.
|}
{{Further|Autopsy}}
{{Bottom}}
