Difference between revisions of "Lung autopsy"

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{{further|Autopsy}}
 
{{further|Autopsy}}
 
===Gross evaluation===
 
===Gross evaluation===
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[[File:Gross pathology of miliary tuberculosis of the lung.jpg|thumb|200px|Gross pathology of miliary "millet seed-like" tuberculosis.]]
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*A spongy consistency, and watery and frothy liquid being pressed from the parenchyma, indicates simple edema.<ref name=Beattie2014>[https://books.google.se/books?id=VIbRAwAAQBAJ&pg=PA62 page 62] in: {{cite book|title=Post-Mortem Methods|author=J. Martin Beattie|publisher=Cambridge University Press|year=2014|isbn=9781107418004}}</ref>
 
*A spongy consistency, and watery and frothy liquid being pressed from the parenchyma, indicates simple edema.<ref name=Beattie2014>[https://books.google.se/books?id=VIbRAwAAQBAJ&pg=PA62 page 62] in: {{cite book|title=Post-Mortem Methods|author=J. Martin Beattie|publisher=Cambridge University Press|year=2014|isbn=9781107418004}}</ref>
 
*A spongy consistency and reddish (blood-stained) fluid being pressed from the parenchyma, indicates acute congestion.<ref name=Beattie2014/>
 
*A spongy consistency and reddish (blood-stained) fluid being pressed from the parenchyma, indicates acute congestion.<ref name=Beattie2014/>
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==Microscopic evaluation==
 
==Microscopic evaluation==
[[File:Histopathology of pulmonary congestion and siderophages.jpg|thumb|Siderophages (one indicated by white arrow), indicating chronic left heart failure. Also pulmonary congestion and lymphocytes, consistent with heart failure.]]
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[[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.]]
 
Most common lung pathologies:<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>
 
Most common lung pathologies:<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).  
 
*Edema and congestion (often together).  
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<gallery>
 
<gallery>
 
File:Histopathology of pulmonary edema.jpg|Edema
 
File:Histopathology of pulmonary edema.jpg|Edema
File:Gross pathology of miliary tuberculosis of the lung.jpg|Gross pathology of miliary "millet seed-like" tuberculosis
 
 
</gallery>
 
</gallery>
  

Revision as of 07:47, 7 January 2020

Author: Mikael Häggström [note 1]
Not including larger pulmonary vessels (instead summarized at Autopsy - Other thorax).

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

Gross pathology of miliary "millet seed-like" tuberculosis.
  • 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

Siderophages (one indicated by white arrow), indicating chronic left heart failure. Also pulmonary congestion and lymphocytes, consistent with heart failure.

Most common lung pathologies:[3][4]

  • Edema and congestion (often together).
  • Acute congestion manifests as alveolar capillaries being engorged with blood, as well as associated alveolar septal edema and/or focal intra-alveolar hemorrhage.[5]
  • Chronic congestion manifests as thickened and fibrotic septa, and alveolar spaces containing numerous siderophages.[5]
  • Pneumonia
  • Tuberculosis in regions with substantial prevalence
  • Carcinoma

Reporting

Report findings and if they are consistent with already known diagnoses. Further information: Autopsy

Notes

  1. 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

  1. 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. 2.0 2.1 2.2 page 62 in: J. Martin Beattie (2014). Post-Mortem Methods . Cambridge University Press. ISBN 9781107418004. 
  3. 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:10.5958/0973-9130.2014.00709.9. ISSN 0973-9122. 
  4. United States: Dr. Stanley Adams. Pulmonary Lung Conditions Found at Autopsy. Washington Forensic Services. Retrieved on 2019-12-20.
  5. 5.0 5.1 . Congestion. Humpath (2005-12-19).

Image sources