Abstract
AIM: To examine current practice and to establish criteria for the use of histopathology in necropsy practice. METHODS: During an audit of necropsy reporting, consensus could not be reached about the use of routine histopathology. Therefore local guidelines were formulated and current practice was compared with these guidelines. Fifteen consecutive necropsies undertaken by each consultant were reviewed and the use of histopathology noted. RESULTS: In general, the standard of necropsy reporting was reasonably high. Tissue was retained for histopathology in 25% of necropsies and 72% of these necropsy reports included a histopathology report. Using the guidelines, the assessors judged that histopathology might have been valuable in a further 19%. It was felt that routine histopathology would not have been helpful in determining the cause of death in the remaining 56%. The importance of the pathologist's clinical judgement in individual cases was stressed. At reaudit, nearly two years later, there was no significant change in practice, reflecting the lack of consensus. CONCLUSIONS: Even when histopathology might contribute to finding the cause of death, it was not always done. However, the assumption that histology is invariably helpful in determining the cause of death is challenged.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Harris A., Ismail I., Dilly S., Maxwell J. D. Physicians' attitudes to the autopsy. J R Coll Physicians Lond. 1993 Apr;27(2):116–118. [PMC free article] [PubMed] [Google Scholar]
- Hunt C. R., Benbow E. W., Knox W. F., McMahon R. F., McWilliam L. J. Can histopathologists diagnose bronchopneumonia? J Clin Pathol. 1995 Feb;48(2):120–123. doi: 10.1136/jcp.48.2.120. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hutchins G. M. Practice guidelines for autopsy pathology. Autopsy performance. Autopsy Committee of the College of American Pathologists. Arch Pathol Lab Med. 1994 Jan;118(1):19–25. [PubMed] [Google Scholar]
- Kleiner D. E., Emmert-Buck M. R., Liotta L. A. Necropsy as a research method in the age of molecular pathology. Lancet. 1995 Oct 7;346(8980):945–948. doi: 10.1016/s0140-6736(95)91561-3. [DOI] [PubMed] [Google Scholar]
- O'Sullivan J. P. The coroner's necropsy in sudden death: an under-used source of epidemiological information. J Clin Pathol. 1996 Sep;49(9):737–740. doi: 10.1136/jcp.49.9.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reid W. A. Cost effectiveness of routine postmortem histology. J Clin Pathol. 1987 Apr;40(4):459–461. doi: 10.1136/jcp.40.4.459. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Start R. D. Practice guidelines for necropsy: time for action. J Clin Pathol. 1996 Nov;49(11):867–868. doi: 10.1136/jcp.49.11.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams J. O., Goddard M. J., Gresham G. A., Wyatt B. A. Audit of necropsy reporting in East Anglia. J Clin Pathol. 1997 Aug;50(8):691–694. doi: 10.1136/jcp.50.8.691. [DOI] [PMC free article] [PubMed] [Google Scholar]