Table Of ContentReinhard B. Dettmeyer
Forensic
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Fundamentals and Perspectives
123
Forensic Histopathology
Reinhard B. Dettmeyer
Forensic Histopathology
Fundamentals and Perspectives
Author
Prof. Dr.Dr. Reinhard B. Dettmeyer
Justus-Liebig-University Gießen
Institute of Forensic Medicine
Frankfurter Straße 58
D-35392 Gießen
Germany
[email protected]
ISBN 978-3-642-20658-0 e-ISBN 978-3-642-20659-7
DOI 10.1007/978-3-642-20659-7
Springer Heidelberg Dordrecht London New York
Library of Congress Control Number: 2011933846
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To my family
Foreword
A review of the relevant specialist literature clearly demonstrates that no new works
on forensic histopathology covering state-of-the-art knowledge and detection meth-
ods have appeared in recent decades.
The present book makes it convincingly clear that forensic histopathology as a
specialist fi eld in its own right within forensic medicine has undergone an expansion
in terms of its required application and, by adopting and applying modern methods of
investigation, has gained in diagnostic importance.
The 20 chapters of this book present the procedures and microscopic analyses
available today for the investigation of almost all injury types seen in humans, includ-
ing postmortem changes, supported to a great extent by excellent color images, as
well as numerous tables and abundant references to the specialist literature.
Particular attention has been paid to interesting and rare drug-, medication-, and other
toxin-related histopathological fi ndings, to which a whole chapter has been devoted.
The present book has striven in particular to provide the basics of forensic medi-
cine, together with tips on application in everyday practice, as well as on recom-
mended staining methods, e.g., when using immunohistochemical techniques.
The knowledge presented here on histomorphological detection methods from a
forensic perspective also has an af fi rmative signi fi cance in terms of application, in
particular when investigating scienti fi c facts which could be used as evidence. In the
future, expert opinions on human injury aiming to satisfy scienti fi c requirements
should be inadmissible if histological fi ndings are not included.
In terms of the administration of justice, the requirement for histological analysis
in forensic practice can also be considered a guideline to ensure that minimum stan-
dards are observed.
The above, however, cannot be reconciled with the often excessively short time
devoted to pathology during a normal forensic residency of only 6 months, a time
period which precludes the possibility of suf fi cient training in microscopic techniques
and fails to re fl ect the importance of histology. This obvious de fi cit needs to be
redressed urgently.Seen as a whole, the present book represents a scienti fi c heavy-
weight endowed with the best characteristics of a specialist textbook and designed to
broaden forensic histological diagnosis while making it more reliable. The book will
be a pleasure to read for any forensic pathologist with an interest in morphology.
Summer 2011, Hamburg, Germany Werner Janssen
vii
Preface
Since the publication of W. Janssens’ “Forensic Histology” more than a quarter of a
century ago, no updated work going beyond a simple atlas on forensic histopathology
and providing the basics, discussing perspectives, and taking new immunohistochem-
ical methods into consideration has been published. At the same time, it must be
noted that both forensic medical training and continuing medical education in the
fi eld of forensic histology and histopathology, i.e., microscopy, are frequently
insuf fi cient. There is often scant awareness of the potential offered by microscopic
investigations to gain forensic insight on the one hand, while on the other, inappropri-
ate staining methods are frequently chosen, staining artifacts are incorrectly inter-
preted, disease patterns remain undetected or wrongly interpreted, or additional
valuable immunohistochemical investigations are simply omitted.
Particularly in forensic medicine, diagnostic questions are encountered which
only histology or histopathology can help answer, e.g., when clarifying a cause of
death, estimating the age of a wound or disease, detecting drug- and medication-
induced fi ndings, or establishing important differential diagnoses, to mention but a
few. It is very much to be desired that these de fi cits will be recognized and that
microscopic diagnosis in forensic medicine will receive greater attention in the
future.
The present book is designed to provide a source of valuable information as well
as a selection from the near unmanageable volume of relevant literature, while dis-
cussing perspectives for further diagnostic options and scienti fi c studies. To this end,
the most important aspects of forensic histopathology and cytological diagnosis are
brought together and discussed – within the obvious constraints – over 20 chapters.
Given the wide spectrum of diseases known to explain death by natural causes, a
selection of frequently observed fi ndings are presented, making their relevance to
general and special pathology evident.
Important fi ndings relevant to a multitude of forensic questions are presented
either in table form or in numerous microscopic images intended to serve as a guide
to the reader’s own microscopy diagnostic procedures. It is the author’s hope that the
potential offered by microscopy to gain insight into scienti fi c studies as well as in
routine diagnostics will gain greater recognition. Such a move would not only serve
the interests of the fi eld of forensic medicine and the responsible police, judicial, and
court authorities, but also those of surviving relatives, for whom clarifying a cause of
death can be an important consolation as well as a useful aid when enforcing legiti-
mate claims.
A complete description of additional and more detailed information on the
signi fi cance of histopathological fi ndings and the use of immunohistochemical mark-
ers relevant to many cases of forensic diagnosis is beyond the scope of this book. This
ix
