biopsy and autopsy Flashcards
Weight range for liver
1,100 – 1,600g
Weight range for brain
1,150 – 1,450g
Weight range for right lung
300-400g
Weight range for left lung
250-350g
Weight range for heart
250-300g
Weight range for spleen
60-300g
Weight range for thyroid
10-50g
Weight range for adrenals
4g each
Excision and examination of tissue from a living subject, ideally at the periphery of the tumor
Biopsy
Desquamated cells examined for hormonal status or chromatin phenotype
Exfoliative cytology
Complete removal of a lesion; most reliable biopsy type
Excisional biopsy
Removal of a part of a lesion or small piece of a tumor by directly incising the capsule; preferred for large tumors that can’t be excised completely
Incisional biopsy
Aspiration of fluid for examination
Needle biopsy
Removal of small pieces of tumor using special forceps
Bite biopsy
Biopsy of skin fragments for analysis
Cutaneous biopsy
Biopsy type for specimens >2mm, embedded in a single paraffin block
Punch biopsy
Biopsy involving curettage specimens
Shave biopsy
Specimen is subdivided with a razor blade for detailed examination
Wedge biopsy
Removal of a tumor by shelling out at the marginal area
Marginal excision
Gold standard for confirming a medical disease and when is it performed
Autopsy: Performed where high-quality medicine is practiced, criminal law enforced, for accurate death certificates, and in research on diseases like cancer, heart disease, stroke.
Requires consent and includes all organs, including the brain.
Complete autopsy
Difference between partial and selective autopsy
Partial: Examines part of the anatomy. Selective: Focuses on a specific organ (e.g., heart for MI).
Preliminaries for PME
- Written consent from next of kin. 2. Death certificate signed by physician/pathologist. 3. Medical data. 4. Medico-legal clearance for foul play.
Other uses of a death certificate
- Burial/cremation. 2. Transport of body. 3. Medical insurance claims (affected by suicide, Acts of God, civil war).
PME without consent circumstances
Ordered by police/coroner, to complete death certificate, prior consent from deceased, or military personnel during active duty.
Jurisdiction of medico-legal examiner/coroner
Can authorize autopsy in cases like natural deaths, injury, violent deaths, unknown/suspicious causes, and deaths without medical attendance.
Criteria for brain death
- Coma & cerebral unresponsiveness 2. Apnea 3. Absent cephalic (brainstem) reflexes 4. Electrocerebral silence (must be present for 30 mins at least 6 hrs after onset of coma & apnea)
Legislative definition of death (1980)
- Irreversible cessation of circulation & respiratory functions 2. Irreversible cessation of all brain functions, including brainstem
American academy of neurology death criteria
- Coma 2. Absence of motor response, pupillary response to light, corneal reflexes, caloric responses, gag reflexes, coughing, sucking & rooting reflexes
Organs removed & dissected individually in the body. Most widely used method.
Technique of Virchow
In-situ dissection combined with en bloc technique.
Technique of Rokitansky
Dissection by cavity, interrelated organs, systemic dissection. Example: thoracic cavity (lungs, heart, diaphragm).
En bloc technique (Rokitansky)
En bloc technique.
Technique of Ghon
En masse technique.
Technique of Letulle
All organs of thoracic, abdominal, & pelvic regions removed at the same time. Sweeping of all organs.
En masse technique (Letulle)
Larynx → Rectum. Very popular, easy to do, convenient.
Autopsy sequence
Organs should be retained completely or partially, set aside later. Body handled by the undertaker.
Consent for organ retention
