Diagnostic Yield of Post-mortem Needle Biopsies and their Spectrum: Experience from a Tertiary Care Hospital

Nigam, Neha; Kumari, Niraj; Krishnani, Narendra; Ranade, Ranjana Shashidhar

doi:10.7860/jcdr/2019/37907.13005

Cited by 2 publications

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“…With the gradual fall in conventional autopsies worldwide, the needle autopsy (also known as postmortem needle biopsy or core needle necropsy) represents a feasible alternative. As seen in our study and others in people who died from COVID-19, it can be performed at the patient's bedside, and the diagnostic accuracy is about 90% compared to conventional autopsy (16)(17)(18), making it a useful tool to better understand the cause of death in these patients.…”

Section: Discussionmentioning

confidence: 58%

“…Conventional autopsy provides important information regarding cause of death as well as clinical and pathological correlation, and it is a paramount source of learning. Postmortem needle biopsy or core needle necropsy has an important role in diagnosis, the generation of knowledge, and quality improvement (16)(17)(18). There are few studies that analyze the clinical, analytical, and radiological factors related with postmortem findings (14).…”

Section: Introductionmentioning

confidence: 99%

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Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies: Correlation With Clinical Presentation and Disease Course

et al. 2022

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BackgroundAutopsies can shed light on the pathogenesis of new and emerging diseases.AimTo describe needle core necropsy findings of the lung, heart, and liver in decedents with COVID-19.MaterialCross-sectional study of needle core necropsies in patients who died with virologically confirmed COVID-19. Histopathological analyses were performed, and clinical data and patient course evaluated.ResultsChest core necropsies were performed in 71 decedents with a median age of 81 years (range 52–97); 47 (65.3%) were men. The median interval from symptoms onset to death was 17.5 days (range 1–84). Samples of lung (n = 62, 87.3%), heart (n = 48, 67.6%) and liver (n = 39, 54.9%) were obtained. Fifty-one lung samples (82.3%) were abnormal: 19 (30.6%) showed proliferative diffuse alveolar damage (DAD), 12 (19.4%) presented exudative DAD, and 10 (16.1%) exhibited proliferative plus exudative DAD. Of the 46 lung samples tested for SARS-CoV-19 by RT-PCR, 39 (84.8%) were positive. DAD was associated with premortem values of lactate dehydrogenase of 400 U/L or higher [adjusted odds ratio (AOR) 21.73; 95% confidence interval (CI) 3.22–146] and treatment with tocilizumab (AOR 6.91; 95% CI 1.14–41.7). Proliferative DAD was associated with an onset-to-death interval of over 15 days (AOR 7.85, 95% CI 1.29–47.80). Twenty-three of the 48 (47.9%) heart samples were abnormal: all showed fiber hypertrophy, while 9 (18.8%) presented fibrosis. Of the liver samples, 29/39 (74.4%) were abnormal, due to steatosis (n = 12, 30.8%), cholestasis (n = 6, 15.4%) and lobular central necrosis (n = 5, 12.8%).ConclusionProliferative DAD was the main finding on lung core needle necropsy in people who died from COVID-19; this finding was related to a longer disease course. Changes in the liver and heart were common.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies: Correlation With Clinical Presentation and Disease Course

et al. 2022

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“…In a Turkish study of postmortem needle biopsies in neonates, successful brain biopsy specimens were obtained in 67% of cases; however, no specific pathological changes were documented in 93% of the specimens [ 33 ]. In a study by Nigam et al (India) [ 34 ], the diagnostic accuracy of postmortem needle biopsies of the brain was 50% in infants. A 2020 study by Hailu et al [ 7 ] (Ethiopia) in preterm deaths showed a brain sampling success rate of 58%.…”

Section: Discussionmentioning

confidence: 99%

Cause of Death in Neonates With Neurological Insults in the Neonatal Intensive Care Unit: Insights From A MITS Pilot Study

Mathew

Lewis

Sreenivas

et al. 2021

Clinical Infectious Diseases

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Background Minimally invasive tissue sampling (MITS) of organs has been used as an alternative to complete diagnostic autopsy in countries where refusal for autopsy in newborns is common for sociocultural reasons. There is a paucity of literature regarding the diagnostic utility of MITS of the brain after death in neonates with neurological insults, especially in India. Methods This was a prospective, preliminary single-center tertiary care hospital study in India, focused specifically on MITS of the brain after neonatal death as a diagnostic tool to identify the various neurological insults. All neonatal deaths with neurological symptoms occurring within the first 30 days of life were enrolled, irrespective of the suspected clinical diagnosis. Results Sixteen neonates were enrolled after death for MITS of the brain, performed for diagnostic purposes, during the study period from February 2020 to March 2021. Their gestational ages ranged from 26 to 38 weeks. All neonates had either a history of seizures and/or respiratory distress or clinical evidence of sepsis and were on ventilator support. Histopathology in all 16 neonates showed evidence of anoxia, with or without reactive astrogliosis or microgliosis. In 5 neonates with cranial ultrasound evidence of brain hemorrhage, MITS of the brain showed intraventricular hemorrhage, subdural hemorrhage, or intraparenchymal white matter microhemorrhages. Premortem blood culture–proven sepsis was seen in 9 neonates. In all cases (100%), MITS had a good diagnostic yield and was useful to establish the neurological insult in the brain. Conclusions MITS of the brain provides an accurate and adequate diagnosis and can be an alternative to complete diagnostic autopsy for establishing the cause of death due to neurological insults, especially in low-resource settings where obtaining consent for more invasive procedure is often challenging.

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Diagnostic Yield of Post-mortem Needle Biopsies and their Spectrum: Experience from a Tertiary Care Hospital

Cited by 2 publications

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Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies: Correlation With Clinical Presentation and Disease Course

Pathological Findings Associated With SARS-CoV-2 on Postmortem Core Biopsies: Correlation With Clinical Presentation and Disease Course

Cause of Death in Neonates With Neurological Insults in the Neonatal Intensive Care Unit: Insights From A MITS Pilot Study

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