Basic autopsy cutting
In non-forensic Autopsy:
- The lungs may be cut after removing the heart through cutting through the major vessels close to it, or by removing each lung by cuts by each lung hilum.
- 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.
- Weigh each lung (possibly first if having cut each lung at the hilus).
- Make some additional sections through the lung parenchyma. Squeeze at each side to detect any pus and edema.
- For context, see Autopsy
- A spongy consistency, and watery and frothy liquid being pressed from the parenchyma, indicates simple edema.
- A spongy consistency and reddish (blood-stained) fluid being pressed from the parenchyma, indicates acute congestion.
- A brownish or dark reddish color of the fluid pressed from the parenchyma indicates chronic congestion, and may not have a spongy consistency.
Generally 10% neutral buffered formalin.
See also: General notes on fixation
- Alveolar fluid. Further information: Alveolar fluid
- 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 information: Chronic pulmonary congestion
- 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 information: Lung tumor
- Aspiration: Other foreign contents in airways. Further information: Aspiration in autopsy
- Embolism of pulmonary arteries.
Carcinoma (in this case bronchioloalveolar cell adenocarcinoma) Further information: Lung tumor
- 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.
- Chronic pulmonary congestion manifests as thickened and fibrotic septa, and alveolar spaces containing numerous pigmented lung macrophages.
Additional potential findings are mentioned in the general Lungs article.
Report findings and if they are consistent with already known diagnoses.
|sideophages indicating chronic heart failure. Prominent vessels, including alveolar capillaries, and a moderate lymphocytic infiltrate, consistent with chronic heart failure or acute decompensation.|
Further information: Autopsy
- Burton, Julian L.; Rutty, Guy N. (2010). The Hospital Autopsy A Manual of Fundamental Autopsy Practice (3rd ed.). Oxford University Press. ISBN 978-0340965146.
- page 62 in: J. Martin Beattie (2014). Post-Mortem Methods . Cambridge University Press. ISBN 9781107418004.
- Standard reference range: Molina, D. Kimberley; DiMaio, Vincent J.M. (2012). "Normal Organ Weights in Men ". The American Journal of Forensic Medicine and Pathology 33 (4): 368–372. doi:10.1097/PAF.0b013e31823d29ad. ISSN 0195-7910.
- Standard reference range: Molina, D. Kimberley; DiMaio, Vincent J. M. (2015). "Normal Organ Weights in Women ". The American Journal of Forensic Medicine and Pathology 36 (3): 182–187. doi:10.1097/PAF.0000000000000175. ISSN 0195-7910.
- 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.
- United States: Dr. Stanley Adams. Pulmonary Lung Conditions Found at Autopsy. Washington Forensic Services. Retrieved on 2019-12-20.
- . Congestion. Humpath (2005-12-19).
- Madea, B (2014). Handbook of forensic medicine . Hoboken, N.J: Wiley-Blackwell. ISBN 978-1-118-57062-3. OCLC 872114659.