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Incidence and clinicopathological significance of DIC in autopsy cases
Insights
Disseminated intravascular coagulation (DIC) is often linked to malignant tumors and hematopoietic diseases. Autopsy studies reveal microthrombi in multiple organs, highlighting DIC
Area of Science:
- Pathology
- Hematology
- Oncology
Background:
- Disseminated intravascular coagulation (DIC) is a complex condition with significant mortality.
- Understanding the pathological basis and underlying causes of DIC is crucial for improved diagnosis and treatment.
- Autopsy studies provide valuable insights into the true incidence and pathological manifestations of DIC.
Purpose of the Study:
- To pathologically examine the incidence and underlying diseases associated with disseminated intravascular coagulation (DIC).
- To investigate the relationship between malignant tumors, hematopoietic diseases, and DIC.
- To identify pathological markers and frequently affected organs in DIC.
Main Methods:
- Retrospective analysis of 4906 autopsy cases over 11 years.
- Pathological confirmation of DIC based on microthrombi in three or more organs.
- Correlation of DIC findings with underlying diseases, including malignant tumors and hematopoietic disorders.
Main Results:
- Pathologically confirmed DIC was found in 88 cases.
- Malignant tumors (40 cases) and hematopoietic diseases (19 cases) were the most frequent underlying conditions.
- Kidney was the most frequently involved organ, with 27 cases showing ischemic lesions due to DIC.
Conclusions:
- Malignant tumors and hematopoietic diseases are significant underlying conditions for DIC.
- Pathological examination is essential for diagnosing DIC, as clinical suspicion may be unreliable.
- Further research into the role of infections and elevated white blood cell counts in DIC development is warranted.
Abstract:
Disseminated intravascular coagulation (DIC) was examined pathologically in 4906 consecutive autopsy cases during the last 11 years. The cases having pathologically confirmed DIC showing microthrombi in three or more organs were 88. Of the underlying diseases for these cases, malignant tumor was found in 40 cases and diseases of hematopoietic organs in 19. Of the cases with malignant tumor, 11 had gastric cancer, 7 had lung cancer, and 4 had pancreatic cancer. Thirty-three of the 40 cases with malignant tumor showed metastasis in two or more organs. Cases with pathologically confirmed or suspected DIC that had microthrombi in one or more organs were 319. As for the incidence of pathologically suggestive DIC in each disease, the incidence of malignant tumor was 7.3% and that for diseases of the hematopoietic organ was 10.6%. Infection is an important underlying condition, especially gram-negative bacillus septicemia which may play an important role in the development of DIC. An increase in the number of white blood cells appears to be one of the causative conditions of DIC. Kidney is involved most frequently by the deposition of microthrombi, and 27 out of 88 cases show ischemic lesions induced by intravascular coagulation. There were 109 cases having clinically diagnosed or suspected DIC, but 67 cases showed no microthrombus formation. On the other hand, 63 among 4,797 cases with clinically unsuspected DIC revealed microthrombus formation in three or more organs by the postmortem examination.
