Histology of the Autopsy

Histology is a valuable part of the autopsy examination. The wise autopsy pathologist will utilise microscopic examination as part of many autopsies. This chapter illustrates autopsy histology arranged by organ systems, covering normal appearances, autopsy artefacts and common and uncommon organ pathology. Histology can be a useful tool to confirm macroscopic features, or to date the findings, for example in acute myocardial infarction, thromboembolism or subdural haemorrhage. There are features of macroscopically identifiable pathology which can be refined and defined using histology. There are some diagnoses which can only be made using histology, for example myocarditis, or the inheritable cardiomyopathies. In an apparently negative autopsy macroscopically, microscopic examination of the organs may reveal a surprise diagnosis such as pyelonephritis or pancreatitis. Regular sampling of the major organs for histology will allow the pathologist to become familiar with the artefacts conferred by the post mortem period and the range of normal features encountered, in order to be able to recognise and define pathology and better understand the pathophysiological processes which led to death.