A Comprehensive Review of Pathological Examination in Forensic Medicine: Past, Present, and Future

Abstract

Pathological examination (PE) encompasses a gross or macroscopy and histopathological or microscopic examination. It is prudent in finding the cause of death (COD) in clinical and medicolegal autopsies. There are various auxiliary techniques in the form of clinical history, communication, specialized training, and protocols for consolidation of the PE results. After a thorough search of the literature in PubMed with relevant keywords along with further analysis of the results, it emerged that even with the modernization of forensic medicine, a PE is unbeatable in detecting the COD. It has various useful aspects, apart from regular finding the COD, such as in student teaching, epidemiology of disease, audit tool, and quality assurance. There are also limitations of PE, which should be dealt with great caution. Hence, limitations must be understood by a forensic expert as well as a pathologist. In this review, all factors that are related to PE in any manner are discussed in detail, and the scope for improving the quality of PE to be relevant in the present scenario is reviewed. It is a comprehensive reassessment of the literature review that also casts light on the future along with a critical analysis of the facts that deal with PE.

A Narrative Review on the Clinical Relevance of Imaging the Circumventricular Brain Organs and Performing Their Anatomical and Histopathological Examination in Acute and Postacute COVID-19

“…When a new disease appears, such as during the recent COVID-19 pandemic, autopsy is the most valuable approach to understanding the disease and gaining insight on how to treat it. [7][8][9][10][11][12][13] At the same time, current neuroimaging methods allow us to study the human brain in clinical settings in a comprehensive, noninvasive way. That said, any neuroimaging methodology must be validated by using brain tissue as the gold standard for comparison, before that methodology can be safely applied in clinical research and practice.…”

“…When a new disease appears, such as during the recent COVID-19 pandemic, autopsy is the most valuable approach to understanding the disease and gaining insight on how to treat it 7–13 . At the same time, current neuroimaging methods allow us to study the human brain in clinical settings in a comprehensive, noninvasive way.…”

The Role of Pathological Examination of the Liver in Medicolegal Autopsy: A Tertiary Care Center Study From North India

“…A pathological examination is not confined to determining the cause of death; it is also useful in teaching the pathogenesis and demography of disease [1]. It helps in the quality assessment of clinical disease retrospectively and the formation of new preventive measures [2][3][4][5][6].…”

“…Clinical and medicolegal autopsies are incomplete without pathological examination. When supplemented with clinical history, gross and histopathological findings may lead to the final cause of death [ 1 ]. A wide range of metabolic, chemical, microbiological, and circulatory insults can harm the liver.…”

Virtual histological staining of unlabeled autopsy tissue

“…The autopsy process mainly involves a gross examination, which encompasses a naked eye-based evaluation of the body and its organs at a macroscopic scale, often followed by multiple organ sampling for microscopic histological examination. This examination provides crucial information by offering insights into cellular and molecular changes that occurred in the deceased tissue, which can further aid in determining the cause and manner of death 2 , enabling a more comprehensive study of the disease progression 2 and evaluating the effectiveness of any medical treatments 3 .…”