Diagnostic Yield of Post-mortem Needle Biopsies and their Spectrum: Experience from a Tertiary Care Hospital EC01-EC04
Dr. Niraj Kumari,
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Introduction: Conventional autopsy provides important information regarding cause of death, clinico-pathological correlation and is a paramount source of learning. Developing countries have low acceptance rates, denial and limited accessibility for conventional autopsy. Needle autopsy has come up as an alternative to conventional autopsy.
Aim: Aim of the study was to analyse postmortem needle biopsies to gauge their utility in lending postmortem diagnosis as well as study its spectrum.
Materials and Methods: This was a retrospective study and includes 334 patients. Different organs sampled were liver, lung, kidney, spleen, brain, heart, testis, lip and nose. Clinical data and histopathology slides were retrieved and reviewed by three pathologists.
Results: A total of 428 biopsies were received from 334 patients. Forty five (10.5%) biopsies from different organs were non representative. A definite diagnosis was offered in 304 biopsies with an overall diagnostic yield of 79.4%. Liver and kidney biopsies had the maximum diagnostic yield of 89.2% and 69.2%, respectively and most diagnostic category encountered were multiacinar necrosis and fungal infection respectively. Major disagreement (Class 1 and Class 2) between clinical diagnosis and needle autopsy diagnosis was found to be in 21/334 cases (6.3%), where patient would potentially have survived if the clinical diagnosis had been correct.
Conclusion: Diagnostic dilemma is a wistful part of medical science. Postmortem needle biopsy has an important role in diagnosis making, improvising the quality of academics and patient care. Level of information and diagnostic yields are high with liver and kidney.