| 2. Two autopsy cases of sudden death showing the usefulness of histopathological findings |
Shuji Kozawa
Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Japan |
Two cases in which a definitive diagnosis was not made by macroscopic examination at autopsy and postmortem computed tomography (CT), but a diagnosis was obtained by histological examination after autopsy are presented to remind those involved in forensic science once again of the importance of histological examination. The first case involved the sudden death of a 5-year-old boy in which the cause of death was not determined at autopsy, but the cause of death was later determined by histological examination. Based on histological examination findings, pulmonary arterial hypertension (PAH) was considered. Genetic testing was conducted for a definitive diagnosis, and a heterozygous insertion of the BMPR2 gene was found. It was concluded that heritable PAH that appeared due to a BMPR2 gene mutation was the disease state in this case. The second case was the sudden death of a woman at 30 weeks of pregnancy in which intracerebral hematoma was found on postmortem CT and autopsy. Based on histological examination findings, a brain tumor, specifically a malignant one, was conceivable, and glioblastoma multiforme (GBM) was strongly suspected. Multiple immunostaining procedures were performed for the definitive diagnosis of the brain tumor. It was concluded the cause of death in this case was in fact GBM, with a secondary glioblastoma with astrocytoma that had undergone malignant progression over some period of time. |
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