Authors: Andrew J. Connolly, MD; Walter E. Finkbeiner, MD; Philip C. Ursell, MD and Richard L. Davis, MD
Publisher: Elsevier – 392 pages
Book Review by: Nano Khilnani

Autopsy is the art and science of postmortem examinations, and this book is useful for practicing pathologists, pathology assistants, trainees, students of pathology, and anyone else interested. This medical specialty, commonly known as the causal study of disease, has many other subspecialties, besides autopsy pathology.

Among other subspecialties are: anatomical pathology (with several sub-sub specialties relating to different parts of the body), clinical pathology, forensic pathology, molecular pathology, oral and maxillofacial pathology, and psychopathology.

The range of subjects this book on autopsy pathology covers is large, and we name its 16 chapters below to give you a broad overview of what you will find within its nearly 400 pages:

  1. The Autopsy – Past and Present
  2. Legal, Social, and Ethical Issues
  3. Autopsy Biosafety
  4. Basic Postmortem Examination
  5. Postmortem Examination of Fetuses and Infants
  6. Special Dissection Procedures
  7. Autopsy Photography and Radiology
  8. Microscopic Examination
  9. Microscopic Findings
  10. Supplemental Laboratory Studies
  11. The Autopsy Report
  12. Sudden Death Due to Natural Causes
  13. Multiple Organ Dysfunction and Sepsis
  14. Death Certification
  15. Quality Management
  16. Atlas of Gross Autopsy Pathology

Appendix A: Description of Gross Autopsy Findings

Appendix B: Measures, Weights, and Assessment of Growth and Development

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While most people see the obvious benefit of autopsy pathology as a means to studying the specific and detailed causes of diseases and death, there are those who question its purpose. In chapter 1, The Autopsy – Past and Present, the various benefits of the autopsy are presented and discussed under the heading The Objectives of the Autopsy. We briefly mention them here:

  • Benefits to Physicians and Health Care Organizations: the establishment of final diagnoses and determination of the cause of death. This is done by correlating physical and laboratory findings with the pathologic changes of disease. In sum, “the autopsy is the gold standard for evaluating the accuracy of a diagnosis and the outcome of therapy,” write the authors
  • Benefits to the Family of the Diseased: in an autopsy, the pathologists can identify and define hereditary or contagious diseases. If a family member dies of a heart attack due to clogged arteries, which was the same cause of his father’s death, this information is vitally important to others in the family who should also undergo a series of cardiac tests,  study the results, and take precautions before becoming victims themselves.
  • Benefits to Public Health: public health surveillance can be achieved through: detection of contagious diseases, identification of environmental hazards, and contribution of accurate vital statistics. These three types of records can be established with autopsies. This can be enabled when the pathologist shares information with public health officials, who in turn speaks to members of the news media.
  • Benefits to Medical Education: Observing a deceased patient in detail, looking at the areas of disease where and how an infection spread for example, is a very valuable method in medical education. This process is real, much better and more effective than seeing full-color photos in a medical textbook. Observing an autopsy is not only useful for the medical student to learn pathology, but also anatomy, histology, and surgery.
  • Benefits to Medical Discovery and Applied Clinical Research: Data from autopsies support as solid evidence as causes of disease and death in the areas of cardiology, hematology, neuroscience, oncology, pulmonology, and other specialties. Molecular examination techniques used in postmortem examinations have identified diseases related to new, emerging infectious agents.
  • Benefits to Basic Biomedical Research: tissues taken from bone, brain, internal organs, muscle, skin, and other parts of the dead patient are helpful for establishing cell and organ cultures, biochemical analysis, morphologic studies, and xeno-transplantation. In short, for enhancing research and understanding the diseases that led to eath. Examining pathologic processes at cellular and molecular levels give us clues to underlying causes.                

 

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Editors:

Andrew J. Connolly, MD is Associate Professor in the Department of Pathology at Stanford University, in Stanford, California.

Walter E. Finkbeiner, MD is Professor and Vice Chair of the Department of Pathology at University of California San Francisco; Chief of Pathology at the Department of Anatomic Pathology at San Francisco General Hospital; and Chief of Pathology at the SFGH Endowed Chair in San Francisco, California.

Philip C. Ursell, MD is Professor in the Department of Pathology at the University of California San Francisco; Director, Autopsy Service at Moffitt-Long Hospital in San Francisco, California.

Richard L. Davis, MD is Professor Emeritus in the Department of Pathology at the University of California San Francisco, in San Francisco, California.