Hospital Autopsy

423 Pages·2015·91.12 MB·English

by  Billie Fyfe

FYFE | MILLER
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Billie Fyfe, MD
Professor of Pathology
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey
Dylan V. Miller, MD
Clinical Associate Professor of Pathology
University of Utah School of Medicine
Director of Electron Microscopy and Immunostains
Intermountain Central Laboratory
Salt Lake City, Utah
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1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
DIAGNOSTIC PATHOLOGY: HOSPITAL AUTOPSY ISBN: 978-0-323-37676-1
Copyright © 2016 by Elsevier. All rights reserved.
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Notices

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Publisher Cataloging-in-Publication Data
Diagnostic pathology. Hospital autopsy / [edited by] Billie Fyfe and Dylan V. Miller.
pages ; cm
Hospital autopsy
Includes bibliographical references and index.
ISBN 978-0-323-37676-1 (hardback)
1. Autopsy--Handbooks, manuals, etc. 2. Autopsy--Methods--Handbooks, manuals, etc.
I. Fyfe, Billie. II. Miller, Dylan V. III. Title: Hospital autopsy.
[DNLM: 1. Autopsy--methods--Atlases. QZ 35]
RB57 .I434 2015
616.07/59--dc23
International Standard Book Number: 978-0-323-37676-1
Cover Designer: Tom M. Olson, BA
Printed in Canada by Friesens, Altona, Manitoba, Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
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Dedications
To the giants who patiently mentored me at Mayo Clinic (Drs. Edwards, Parisi,
(cid:2)(cid:3)(cid:4)(cid:4)(cid:5)(cid:6)(cid:7)(cid:8)(cid:9)(cid:10)(cid:11)(cid:5)(cid:6)(cid:7)(cid:12)(cid:13)(cid:5)(cid:11)(cid:14)(cid:6)(cid:7)(cid:15)(cid:16)(cid:17)(cid:7)(cid:18)(cid:19)(cid:20)(cid:21)(cid:19)(cid:20)(cid:11)(cid:22)(cid:7)(cid:15)(cid:16)(cid:17)(cid:7)(cid:23)(cid:24)(cid:20)(cid:7)(cid:15)(cid:13)(cid:15)(cid:25)(cid:21)(cid:16)(cid:26)(cid:7)(cid:27)(cid:9)(cid:28)(cid:28)(cid:3)(cid:11)(cid:23)(cid:7)(cid:27)(cid:23)(cid:15)(cid:29)(cid:7)(cid:3)(cid:19)(cid:7)(cid:23)(cid:24)(cid:20)(cid:7)(cid:3)(cid:4)(cid:17)(cid:7)
Baldwin basement and later Stabile 9. To Drs. Collins and Sinard and many
colleagues on the CAP Autopsy Resource Committee for opening my eyes to a
wider world of pathology practice. To the many able minds who helped conceive,
gestate, and deliver the book’s content and whose names dignify its pages. To
Dave, Angie, and Kellie at Amirsys/Elsevier for their patience and trust. And most
of all to Tonya, for her undying tolerance and support.
DVM
This book is dedicated with gratitude to my mentors, who gave me the courage
and opportunity to pursue autopsy pathology, and to my mentorees, who make
the work so rewarding. This project would not have been possible without
the forward vision of the Amirsys/Elsevier team, especially Angela Terry, who
supported this unique addition to their pathology collection, and the tremendous
expertise shared by Dylan Miller and all of the authors. As always, I must thank
my sons, Justin and Alexander, who make everything worthwhile, and my
parents, who encouraged me from the beginning.
BF
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Contributing Authors
Brandon T. Larsen, MD, PhD Leslie A. Litzky, MD
Assistant Professor of Pathology Professor, Department of Pathology and
Department of Pathology Laboratory Medicine
Banner – University Medical Center Perelman School of Medicine
University of Arizona College of Medicine University of Pennsylvania
Tucson, Arizona Chief, Section of Medical Pathology,
Hospital of the University of Pennsylvania
Subspecialty Director, Thoracic Pathology,
Monica P. Revelo, MD, PhD Section of Surgical Pathology
Philadelphia, Pennsylvania
Professor of Pathology
Department of Pathology
University of Utah School of Medicine
Salt Lake City, Utah Harold Sanchez, MD, FCAP
Associate Chief of Pathology
Department of Pathology
Rebecca A. Irvine, MD, FRCPA Hospital of Central Connecticut
New Britain, Connecticut
(cid:2)(cid:3)(cid:4)(cid:5)(cid:6)(cid:7)(cid:8)(cid:2)(cid:9)(cid:10)(cid:11)(cid:8)(cid:2)(cid:12)(cid:3)(cid:13)(cid:5)(cid:10)(cid:14)(cid:5)(cid:15)(cid:9)(cid:16)(cid:8)(cid:17)(cid:6)(cid:7)(cid:3)(cid:4)(cid:15)(cid:5)(cid:13)(cid:8)(cid:18)(cid:10)(cid:9)(cid:19)(cid:6)(cid:14)(cid:6)(cid:20)(cid:21)
(cid:22)(cid:3)(cid:12)(cid:10)(cid:7)(cid:9)(cid:23)(cid:3)(cid:4)(cid:9)(cid:8)(cid:6)(cid:24)(cid:8)(cid:17)(cid:6)(cid:7)(cid:3)(cid:4)(cid:15)(cid:5)(cid:13)(cid:8)(cid:25)(cid:3)(cid:26)(cid:5)(cid:13)(cid:5)(cid:4)(cid:3)(cid:16)(cid:8)(cid:2)(cid:21)(cid:26)(cid:4)(cid:3)(cid:21)
(cid:27)(cid:2)(cid:28)(cid:8)(cid:17)(cid:6)(cid:7)(cid:3)(cid:4)(cid:15)(cid:5)(cid:13)(cid:8)(cid:10)(cid:4)(cid:26)(cid:8)(cid:29)(cid:4)(cid:10)(cid:14)(cid:21)(cid:9)(cid:5)(cid:13)(cid:10)(cid:14)(cid:8)(cid:2)(cid:13)(cid:5)(cid:3)(cid:4)(cid:13)(cid:3)(cid:8)(cid:2)(cid:3)(cid:7)(cid:30)(cid:5)(cid:13)(cid:3)
Glebe, NSW, Australia Roy H. Rhodes, MD, PhD
Professor
Director, Neuropathology
George P. Batsides, MD Medical Director, RWJUH EM Services
Department of Pathology
Assistant Professor of Surgery
Rutgers Robert Wood Johnson Medical School
Chief, Section of Cardiac Surgery
New Brunswick, New Jersey
Surgical Director, Mechanical Circulatory Support
Division of Cardiac Surgery
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey Paisit Paueksakon, MD
Associate Professor
Associate Director
(cid:2)(cid:3)(cid:4)(cid:5)(cid:6)(cid:5)(cid:3)(cid:7)(cid:8)(cid:9)(cid:6)(cid:4)(cid:10)(cid:4)(cid:11)(cid:4)(cid:5)(cid:12)(cid:13)(cid:7)(cid:14)(cid:15) Division of Renal Pathology/Electron Microscopy
(cid:10)(cid:4)(cid:26)(cid:8)(cid:31)(cid:3)(cid:4)(cid:10)(cid:14)(cid:8)(cid:18)(cid:10)(cid:9)(cid:19)(cid:6)(cid:14)(cid:6)(cid:20)(cid:21)(cid:8)(cid:17)(cid:3)(cid:14)(cid:14)(cid:6)!(cid:15)(cid:19)(cid:5)(cid:12)
Anatomic and Clinical Pathology Resident
Department of Pathology, Microbiology, and Immunology
Department of Pathology
Vanderbilt University Medical Center
Rutgers Robert Wood Johnson Medical School
Nashville, Tennessee
New Brunswick, New Jersey
Hasini Reddy, MD, DPhil
Christine Minerowicz, MD
Department of Pathology, Dalhousie University
Resident of Pathology
Director of Neuropathology
Department of Laboratory Medicine and Pathology
The Moncton Hospital
Rutgers Robert Wood Johnson Medical School
Moncton, New Brunswick, Canada
New Brunswick, New Jersey
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Rachel Hudacko, MD
Medical Director, Department of
Pathology/Laboratory
St. Anthony Community Hospital
Warwick, New York
Clinical Instructor, Department of Pathology
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey
Patrick Lento, MD
Professor of Clinical Pathology and Medicine
New York Medical College
Valhalla, New York
Corinne L. Fligner, MD
Professor, Department of Pathology
Adjunct Professor, Department of
Laboratory Medicine
Director, Autopsy and After Death
Services, UW Pathology
University of Washington
Seattle, Washington
Vidhya Nair, MBBS, MD, FRCPC
Associate Professor
Department of Pathology and Molecular Medicine
McMaster University
Cardiovascular Pathologist, Hamilton Health Sciences
Hamilton, Ontario, Canada
Elizabeth H. Hammond, MD
Professor of Pathology and Adjunct Professor
of Medicine (Cardiology)
University of Utah School of Medicine
Pathology Consultant
Intermountain Healthcare
Salt Lake City, Utah
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Preface
Declining rates of hospital autopsies have not diminished the enthusiasm of those of us who
(cid:12)(cid:7)(cid:10)(cid:13)(cid:9)(cid:5)(cid:13)(cid:3)(cid:8)(cid:9)(cid:19)(cid:5)(cid:15)(cid:8)"(cid:3)(cid:14)(cid:26)(cid:8)(cid:6)(cid:24)(cid:8)(cid:12)(cid:10)(cid:9)(cid:19)(cid:6)(cid:14)(cid:6)(cid:20)(cid:21)#(cid:8)$(cid:19)(cid:5)(cid:15)(cid:8)(cid:23)%(cid:14)(cid:9)(cid:5)&(cid:10)%(cid:9)(cid:19)(cid:6)(cid:7)(cid:8)(cid:9)(cid:3)’(cid:9)(cid:8)(cid:9)(cid:19)(cid:10)(cid:9)(cid:8)(cid:13)(cid:6)(cid:23)*(cid:5)(cid:4)(cid:3)(cid:15)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)(cid:9)(cid:10)(cid:14)(cid:3)(cid:4)(cid:9)(cid:15)(cid:8)(cid:6)(cid:24)(cid:8)(cid:23)(cid:10)(cid:4)(cid:21)(cid:8)
(cid:3)’(cid:12)(cid:3)(cid:7)(cid:9)(cid:15)(cid:8)(cid:5)(cid:4)(cid:8)(cid:9)(cid:19)(cid:5)(cid:15)(cid:8)"(cid:3)(cid:14)(cid:26)(cid:8)(cid:5)(cid:15)(cid:8)(cid:10)(cid:8)!(cid:5)(cid:9)(cid:4)(cid:3)(cid:15)(cid:15)(cid:8)(cid:9)(cid:6)(cid:8)(cid:9)(cid:19)(cid:5)(cid:15)#
Engaging young pathologists in autopsy is vital to preserving what is arguably the bedrock of all
pathology knowledge. This volume aims to present the hospital autopsy as it is really practiced
— with real case presentations, approaches to dissection, chart review focusing, and reporting
(cid:15)%(cid:20)(cid:20)(cid:3)(cid:15)(cid:9)(cid:5)(cid:6)(cid:4)(cid:15)#(cid:8)$(cid:19)(cid:5)(cid:15)(cid:8)(cid:5)(cid:15)(cid:16)(cid:8)(cid:5)(cid:4)(cid:8)(cid:12)(cid:10)(cid:7)(cid:9)(cid:16)(cid:8)(cid:5)(cid:4)(cid:9)(cid:3)(cid:4)(cid:26)(cid:3)(cid:26)(cid:8)(cid:9)(cid:6)(cid:8)(cid:10)(cid:15)(cid:15)(cid:5)(cid:15)(cid:9)(cid:8)(cid:5)(cid:4)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)(cid:9)(cid:7)(cid:10)(cid:5)(cid:4)(cid:5)(cid:4)(cid:20)(cid:8)(cid:10)(cid:4)(cid:26)(cid:8)+%(cid:15)(cid:9)&(cid:5)(cid:4)&(cid:9)(cid:5)(cid:23)(cid:3)(cid:8)(cid:12)(cid:7)(cid:3)(cid:12)(cid:10)(cid:7)(cid:10)(cid:9)(cid:5)(cid:6)(cid:4)(cid:8)(cid:24)(cid:6)(cid:7)(cid:8)
trainees and new pathologists, as well as those who unfortunately don’t get the chance to
perform autopsies routinely.
The format follows other volumes related to surgical pathology in the Diagnostic Pathology
(cid:15)(cid:3)(cid:7)(cid:5)(cid:3)(cid:15)#(cid:8)(cid:29)(cid:9)(cid:8)"(cid:7)(cid:15)(cid:9)(cid:16)(cid:8)"(cid:9)(cid:9)(cid:5)(cid:4)(cid:20)(cid:8)(cid:10)(cid:4)(cid:8)(cid:10)%(cid:9)(cid:6)(cid:12)(cid:15)(cid:21)(cid:8)(cid:9)(cid:3)’(cid:9)(cid:8)(cid:5)(cid:4)(cid:9)(cid:6)(cid:8)(cid:15)%(cid:13)(cid:19)(cid:8)(cid:10)(cid:8)(cid:24)(cid:6)(cid:7)(cid:23)(cid:10)(cid:9)(cid:8)!(cid:10)(cid:15)(cid:8)(cid:13)(cid:19)(cid:10)(cid:14)(cid:14)(cid:3)(cid:4)(cid:20)(cid:5)(cid:4)(cid:20)(cid:8)*%(cid:9)(cid:8)%(cid:14)(cid:9)(cid:5)(cid:23)(cid:10)(cid:9)(cid:3)(cid:14)(cid:21)(cid:8)(cid:23)(cid:10)(cid:26)(cid:3)(cid:8)
sense as a way to emphasize the role that autopsy plays in modern medicine. Making diagnoses
(cid:10)(cid:9)(cid:8)(cid:10)%(cid:9)(cid:6)(cid:12)(cid:15)(cid:21)(cid:8)(cid:10)(cid:4)(cid:26)(cid:8)(cid:13)(cid:6)(cid:7)(cid:7)(cid:3)(cid:14)(cid:10)(cid:9)(cid:5)(cid:4)(cid:20)(cid:8)(cid:9)(cid:19)(cid:3)(cid:23)(cid:8)(cid:13)(cid:14)(cid:5)(cid:4)(cid:5)(cid:13)(cid:10)(cid:14)(cid:14)(cid:21)(cid:8)(cid:5)(cid:15)(cid:8)(cid:4)(cid:6)(cid:9)(cid:8)(cid:24)%(cid:4)(cid:26)(cid:10)(cid:23)(cid:3)(cid:4)(cid:9)(cid:10)(cid:14)(cid:14)(cid:21)(cid:8)(cid:26)(cid:5)(cid:11)(cid:3)(cid:7)(cid:3)(cid:4)(cid:9)(cid:8)(cid:24)(cid:7)(cid:6)(cid:23)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)(cid:26)(cid:5)(cid:10)(cid:20)(cid:4)(cid:6)(cid:15)(cid:9)(cid:5)(cid:13)(cid:8)
processes in surgical pathology.
One key distinction between autopsy and surgical pathology is the number of stakeholders
(cid:10)(cid:11)(cid:3)(cid:13)(cid:9)(cid:3)(cid:26)(cid:8)*(cid:21)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)(cid:10)%(cid:9)(cid:6)(cid:12)(cid:15)(cid:21)(cid:8)(cid:26)(cid:5)(cid:10)(cid:20)(cid:4)(cid:6)(cid:15)(cid:5)(cid:15)-(cid:8)"(cid:7)(cid:15)(cid:9)(cid:8)(cid:10)(cid:4)(cid:26)(cid:8)(cid:24)(cid:6)(cid:7)(cid:3)(cid:23)(cid:6)(cid:15)(cid:9)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)(cid:4)(cid:3)’(cid:9)(cid:8)(cid:6)(cid:24)(cid:8)0(cid:5)(cid:4)(cid:16)(cid:8)(cid:9)(cid:19)(cid:3)(cid:4)(cid:8)(cid:13)(cid:10)(cid:7)(cid:3)(cid:20)(cid:5)(cid:30)(cid:3)(cid:7)(cid:15)(cid:16)(cid:8)(cid:19)(cid:3)(cid:10)(cid:14)(cid:9)(cid:19)(cid:8)
(cid:13)(cid:10)(cid:7)(cid:3)(cid:8)(cid:15)(cid:21)(cid:15)(cid:9)(cid:3)(cid:23)(cid:15)(cid:16)(cid:8)(cid:10)(cid:4)(cid:26)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)(cid:13)(cid:6)(cid:23)(cid:23)%(cid:4)(cid:5)(cid:9)(cid:21)#(cid:8)1(cid:9)(cid:8)(cid:5)(cid:15)(cid:8)(cid:6)%(cid:7)(cid:8)(cid:19)(cid:6)(cid:12)(cid:3)(cid:8)(cid:9)(cid:19)(cid:10)(cid:9)(cid:8)(cid:9)(cid:19)(cid:5)(cid:15)(cid:8)(cid:9)(cid:3)’(cid:9)(cid:8)!(cid:5)(cid:14)(cid:14)(cid:8)(cid:5)(cid:23)(cid:12)(cid:7)(cid:6)(cid:30)(cid:3)(cid:8)(cid:9)(cid:19)(cid:3)(cid:8)2%(cid:10)(cid:14)(cid:5)(cid:9)(cid:21)(cid:8)(cid:6)(cid:24)(cid:8)(cid:19)(cid:6)(cid:15)(cid:12)(cid:5)(cid:9)(cid:10)(cid:14)(cid:8)
autopsies, impact families and communities through the answers that the autopsy can provide,
and help pathologists enjoy the diagnostic journey.
Billie Fyfe, MD
Professor of Pathology
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey
Dylan V. Miller, MD
Clinical Associate Professor of Pathology
University of Utah School of Medicine
Director of Electron Microscopy and Immunostains
Intermountain Central Laboratory
Salt Lake City, Utah
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