When it comes to laboratory testing at autopsy, our options are limited compared to those for living patients. We’ve previously discussed the complexities of postmortem toxicology testing (https://labmedicineblog.com/2023/05/23/toxicology-and-forensic-pathology-more-than-a-numbers-game/) but even basic laboratory studies like a glucose or sodium level cannot be reliably measured from postmortem serum specimens. Upon death, hemolysis and cellular breakdown rapidly set ..read more

A 20 year old female patient referred herself to a surgical oncologist specializing in sarcomas after she presented to an outside hospital for a sudden onset of epigastric pain. The patient also reported a one-year history of decreased appetite without nausea, vomiting, or weight loss. The outside institution performed an abdominal ultrasound and identified a ..read more

I like to think most people who go into healthcare professions do so with the hope of helping others. For those of us who do autopsies, the greatest sense of reward comes when we can explain to someone how and why their loved one died. Inevitably, though, there will be situations where we need to ..read more

In several previous blogs, I’ve mentioned the topic of post-mortem radiography (or “x-rays”). While postmortem CT scanning is a hot topic in the field, plain films are a tool which has been in widespread use for decades. Autopsy standards of the National Association of Medical Examiners require, at a minimum, radiographs be performed on all ..read more

In the United States, victims of gunshot wounds represent a significant majority of all homicides (and a high proportion of suicides). There’s a propensity among other medical specialties to think of forensic pathologists as “bullet pullers,” just collecting the used projectiles and moving on to the next case. However, autopsies of multiple gunshot wound victims ..read more

With warmer weather approaching (or already arrived, depending on your location), it’s a good opportunity to review investigation of drowning deaths in forensic pathology. Drowning is the leading cause of deaths for children between the ages of 1 and 4 in the United States, but it can affect any age group. Drowning is a diagnosis ..read more

Against the backdrop of COVID-19, the world experienced a multicounty outbreak of Mpox (formally monkeypox) beginning in May of 2022. Prior to that time, the virus was primarily known to circulate within central and west African nations causing zoonotic disease. Clinical presentations of Mpox comprise signs and symptoms including rash on the hands, feet, face ..read more

I was recently reviewing new toxicology reports from my pending autopsies, and came across a report with the following results:  Looking at this in isolation, it would be easy to assume this person died from an overdose. Even low levels of fentanyl can be dangerous to an opioid-naive individual – a level this high is ..read more

I’ve found that our cytologists have a love-hate relationship with thyroids. Pathologists do too. Or it could be that we see so many goiters (50%) and follicular lesions or atypia of undetermined significance (35%) that the rare papillary thyroid carcinoma is a gem in our eyes. Minimally-invasive thyroid FNAs are instrumental in the management of ..read more

Emergency services were called to a fire in a small apartment building, in which the structure was completely engulfed. Most of the occupants had been evacuated – however, once the fire was extinguished, the charred remains of an adult woman were found in the debris. At the autopsy of severely fire-damaged human remains, two key ..read more