M.B. Patekar, Assistant Professor, Department of Forensic Medicine & Toxicology, Punyashlok Ahilyadevi Holkar Government Medical College, Baramati, Maharashtra,, India
Abhishek Bhimrao Muley Assistant Professor, Department of Pathology, Grant Government Medical College, Mumbai, Maharashtra,, India
Ketaki Jayant Patil Senior Resident, Department of Obstetrics & Gynecology, Jagajeevan Ram Hospital, Mumbai Central, Mumbai, Maharashtra,, India
Nikhil S. Jagtap Forensic Medicine, Assistant Professor, Department of Forensic Medicine and Toxicology, Rajarshee Chattrapati Shahu Maharaj Government Medical College and Chhatrapati Pramilatai Raje Hospital, Kolhapur, Maharashtra,, India
Address for correspondence: M.B. Patekar,, Assistant Professor, Department of Forensic Medicine & Toxicology, Punyashlok Ahilyadevi Holkar Government Medical College, Baramati, Maharashtra,, India E-mail: drmanojpatekar@gmail.com
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
1. Muley AB, Patekar MB, et al. Beyond the Gross: Unveiling the Microscopic Truth in 3 Autopsy Cases. Ind J Pathol Res Pract. 2025;14(2):72-79.
Timeline
Received : May 08, 2025
Accepted : June 06, 2025
Published : August 10, 2025
Abstract
Histopathology, the microscopic examination of tissues, is a keystone of the autopsy examination, providing critical understandings outside what can be observed with the gross examination. In medicolegal autopsies, where the cause and manner of death may be unclear or contested, histopathology plays an especially vital role. This case series emphasizes the important role of histopathological examination in medicolegal autopsies. We present three cases where microscopic tissue exploration through histopathology provided essential
information that significantly impacted the final determination of the cause and/ or manner of death. In the first case, histopathology revealed subtle myocardial changes indicative of a previously unsuspected cardiac event. The second case demonstrated the utility of histopathology in distinguishing death due to rupture of hepatic cyst from alleged death due to blunt trauma. Finally, the third case highlights how microscopic evaluation identified a lethal but grossly undetectable disease process related to amniotic fluid embolism in a postoperative case. These
cases illustrate that histopathology is a crucial tool in medicolegal investigations, often providing critical evidence that macroscopic gross examination alone cannot
References
1. Shubhendu K., Mundri S., Kumar S., Kumar A. The Impact of Histopathology on Medical Board Autopsies. Cureus. 2025 Feb 7; 17(2): e78675. doi: 10.7759/cureus.78675. PMID: 40062106; PMCID: PMC11890611.
5. Molina D.K., Wood L.E., Frost R.F. Is routine histopathological examination beneficial in all medicolegal autopsies? Am J Forensic Med Pathol. 2007; 28: 1-3.
6. Guareschi E.E. The Role of Histology in Forensic Investigations. Preprints.org (www.preprints. org) | Not Peer-Reviewed | Posted: 20 March 79 IJPRP / Volume 14 Number 2 May – August 2025 Abhishek Bhimrao Muley, Manoj B. Patekar, et al. Beyond the Gross: Unveiling the Microscopic Truth in 3 Autopsy Cases. 2024 doi:10.20944/preprints202403.1133.v1
7. Mukherjee B., Ropmay, Slong D., et al. (March 23, 2025) Role of Histopathology in Determining the Cause of Death in Medicolegal Autopsies. Cureus 17(3): e81055. doi:10.7759/ cureus.81055
8. Banwari M. An erroneous opinion on a cause of death in a forensic autopsy: a case report. Afr Health Sci. 2017 Dec; 17(4): 1246-1249. doi: 10.4314/ahs.v17i4.36. PMID: 29937899; PMCID: PMC5870277.
9. Jhajj K.K., Nibhoria S. et al. A study of histopathological examination in medicolegal Autopsies in Faridkot, Punjab.Ind.Journal of FMT: 2013. 7(1): 76-81.
10. Zenati H. Hydatid peritonitis caused by liver hydatid cyst rupture into the peritoneal cavity: A case report Hanen Zenati. International Journal of Surgery Case Reports cavity: A case report Hanen Zenati. International Journal of Surgery Case Reports
11. Noone P.H. Training in Forensic Histopathology-Significance in Postgraduate Curriculum of Forensic Medicine. Journal of Evidence Based Medicine and Health Care. September 2014. 1(7): 595-598
12. McDougall, Robert J and Graeme J Duke. “Amniotic Fluid Embolism Syndrome: Case Report and Review.” Anaesthesia and Intensive Care 23.1995: 735-740.
13. Schandl C.A., Collins K.A. Maternal Autopsy. In: Collins K.A. editor. Autopsy performance and reporting. 2nd ed. Northfield (IL): College of American Pathologists; 2002. p. 135-49.
14. Hikiji W., Tamura N., Shigeta A., et al. Fatal amniotic fluid embolism with typical pathohistological, histochemical and clinical features. Forensic Sci Int. 2013 Mar 10; 226 (1-3): e16-9. PMID: 23273942. https://doi. org/10.1016/j.forsciint.2012.12.008.
15. Role of Histopathological Examination in Medicolegal Autopsies in Unravelling Precise Causes of Mortality. National Journal of Laboratory Medicine. 2021 Oct, Vol-10(4): PO01-PO04.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest.
About this article
Cite this article
1. Muley AB, Patekar MB, et al. Beyond the Gross: Unveiling the Microscopic Truth in 3 Autopsy Cases. Ind J Pathol Res Pract. 2025;14(2):72-79.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Gross of heart showing white fibrotic patch near apex with tiny hemorrhagic areas. LAD showing near complete occlusion
Description: Liver was enlarged, weighing 2050 gms, yellowish at places, firm in consistency, with
rupture of whitish cystic nodules over the right lobe. On cut section, it shows multiple small
cysts containing whitish cystic fluid within the parenchyma of the liver. (Figure 1 & 2)
Microscopy (2a and 2b) shows evidence of old healed myocardial infarction, myocardial hypertrophy, lymphocytic and few neutrophilic inflamatory infiltrate with myocytolysis along with haemorrhages within the myocardium-suggestive of acute myocardial infarction
Description: Liver was enlarged, weighing 2050 gms, yellowish at places, firm in consistency, with rupture of whitish cystic nodules over the right lobe. On cut section, it shows multiple small cysts containing whitish cystic fluid within the parenchyma of the liver. (Figure 2)
Gross of liver showing single large cystic cavity with whitish contents inside
Description: No description available.
Microscopy of hydatid cyst showing numerous free hooklets and daughter cysts with protoscolices