A five year study of lung lesions in medico-legal autopsies from a pathologist’s perspective

Introduction: A wide variety of pathologic conditions involve the lungs. The lungs are also involved in almost all terminal events of cardiovascular disease. Autopsy is important not only to determine the state of lungs at death but also to study the morphology of various diseases. Aims and objectives of study are to identify the histopathological spectrum of lung lesions and to find out the frequency of various lung pathologies in respect to age and sex. Materials and Methods: This was a retrospective study of medico legal autopsies over a period of five years. The lung tissue was fixed and processed. Routine paraffin sectioning was done followed by Haematoxylin and eosin (H and E) staining. Special stains were done when required. Relevant clinical, postmortem findings, gross and microscopic examination findings were recorded. Results: After thorough histopathological examinations, of total 412 cases, various pulmonary lesions were identified in 349 (84.6%) cases, in 23 (5.6%) of cases tissue was autolysed and 40 (9.8 %) of cases were histologically unremarkable. Most commonly affected age group was 30-49 years, with males being predominantly affected. The changes seen were - Congestion & edema 116 (33.2%), pneumonia 68(19.6%), interstitial changes 52 (15.1%), emphysema- 26 (7.5%), chronic venous congestion 30 (8.6%), abscess (1.1%), haemorrhage (6.4%) tuberculosis -11(3.3%), bronchiolitis- 3 (0.8%), asthama- 2(0.5%), ARDS- 7 (1.9%), lung cysts- 2 (0.5%) Conclusions: Though the pulmonary diseases are commonly encountered clinically, studying of lung tissues submitted for autopsy, not only gives us an insight into the histology of varying stages of different diseases but also is an important educative tool for the forensic pathologists.