Histomorphological Lung Changes and Cause of Death Correlation: An Autopsy Based Study in a Tertiary Care Centre

• Main Authors: Thej Mothakapalli Jagadish, Thomas Alex Kodiatte, Harendra Kumar Malligere-Lingaiah, Kiran Jayaramaiah
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-06-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: alveolar haemorrhage; diffuse alveolar damage; pulmonary oedema
• Online Access: https://jcdr.net/articles/PDF/12929/41472_CE[Ra1]_F(SL)_PF1(AJ_SHU)_PN(SL).pdf

Introduction: Organ-specific pathological changes that are seen during autopsy give a clearer picture of the cause of death and help to correlate with the clinical scenario. Aim: To study the histomorphological lung changes seen at autopsy and to correlate them with the clinical cause of death. Materials and Methods: Lung specimens were collected from 120 autopsies conducted at a tertiary care hospital in coordination with the Department of Forensic Medicine during a two-year period. Grossly, both lungs were carefully examined for any morphological changes. Histological studies were performed on the representative bits taken. The sections were examined for congestion, oedema, haemorrhage, hyaline membranes, inflammation, alveolar collapse/thinning, alveolar wall disturbances, capillary dilatation and micro-organisms. Results: Majority of patients belonged to the third decade of life. The most common cause of death was Road Traffic Accidents (RTAs). Majority RTA victims were males and all burns victims were females. The commonly seen morphological features were pulmonary congestion, pulmonary oedema and alveolar haemorrhage. Diffuse Alveolar Damage (DAD) was only seen in 13.5% of cases. Conclusion: The histological findings seen in the RTA cases were associated with circulatory failure manifesting in the lungs as alveolar haemorrhage, congestion and oedema, microvascular damage and eventually multi-organ injury. DAD was more commonly observed in cases of poison and burns than in RTAs. The most frequent manner of deaths was accidents (RTA), followed by suicides (poisoning and burns) and sudden death. Autopsy including histology plays an important role in the evaluation of the cause of death.