Usefulness of computed tomography-guided postmortem biopsy to evaluate pneumonia

Area of Science:

• Forensic Pathology
• Radiology
• Medical Diagnostics

Background:

• Pneumonia diagnosis in postmortem cases presents challenges.
• Traditional methods like postmortem CT (PMCT) and blood markers may not always detect pneumonia accurately.
• Histopathology remains the gold standard but is invasive.

Purpose of the Study:

• To assess the feasibility of computed tomography (CT)-guided postmortem lung biopsy for diagnosing pneumonia.
• To compare diagnostic findings from PMCT and blood analyses with histopathological results.

Main Methods:

• Included 13 patients with histopathologically confirmed neutrophil infiltration within 3 days of death.
• All patients underwent PMCT, followed by CT-guided postmortem lung biopsy.
• Postmortem blood samples were analyzed for C-reactive protein (CRP) and presepsin (P-SEP).

Main Results:

• PMCT showed pulmonary hypostasis in 38.5% of cases and various abnormal appearances (reticular, ground-glass, patchy, nodular) in others.
• All measurable CRP levels exceeded normal ranges, while P-SEP levels were normal in 16.7% of cases.
• CT-guided biopsy successfully identified pneumonia, even when PMCT and blood markers were inconclusive.

Conclusions:

• Diagnosing postmortem pneumonia solely through PMCT and blood tests has limitations.
• CT-guided postmortem lung biopsy is a valuable tool for identifying pneumonia when other methods fail.
• This technique enhances diagnostic accuracy in challenging postmortem cases.