Forensic Pathology for Police - Brainshare Public Online Library

154 7 The Postmortem Forensic Examination/Autopsy
office’s toxicology testing. Common sample types include urine and blood, but other
samples may include cerebral spinal fluid (CSF), bile, vitreous (eye fluid), gastric
contents, and various solid organs (liver, kidney, brain). In general, peripheral blood
(femoral) is better than central blood (heart). It is important to label the collection
site for every sample collected. Regarding blood, it is important to collect some sample
in tubes containing sodium fluoride (gray-top tubes). Other specific test types
may require special tube types, and consultation with the toxicology laboratory is
advised so that samples are collected appropriately.
Certain postmortem chemistry tests can also be performed; some of these involve
blood, but the most common type involves vitreous fluid. The reader is referred to
Chapter 21 for a detailed description of the tests available. Certain serology tests,
wherein specific antigens and/or antibodies are detected, and certain microbiology
tests, can be performed in postmortem samples. Bacterial, fungal, and viral cultures
may or may not be reliable after death and results should be interpreted in light of
other autopsy findings.
Histology is the term used to describe the process by which the microscopic
anatomy of a tissue is evaluated. As discussed above, there are certain cases where
it becomes necessary for the forensic pathologist to look at the microscopic appearance
of an organ or tissue. Protocols for which cases require histologic examination
vary from one office to the next, and in some offices, every case (other than skeletal
remains) has histology performed. Similarly, protocols regarding which tissues
need to be examined vary from office to office and from pathologist to pathologist;
however, there are certain cases that always require histologic examination in order
to determine the cause of death. Routine histology involves the processing of small
samples of organs and tissues such that stained, extremely thin, sections of tissues
are placed on glass slides for visualization under a microscope. The routine stain
that is used by many pathologists is the hematoxylin and eosin (H&E) stain. Other
special stains can be used to help identify certain things, such as micro-organisms or
scar tissue. Highly-specialized staining techniques known as immunohistochemistry
or immunoperoxidase or in-situ hybridization (a type of molecular test) staining can
be used in selected cases for identifying more complex or specialized substances or
micro-organisms.
In addition to histology, the forensic pathologist may have an entire battery
of additional test types or consultations available to assist in the diagnosis of
various diseases or abnormalities. These include, but are not limited to, DNA testing,
other molecular tests, biochemical testing, and genetic/chromosomal testing.
Consultation with other medical/pathology specialists, such as cardiac pathologists
and neuropathologists, is sometimes available. Consultation with other forensic scientists,
such as anthropologists, toxicologists, odontologists, and entomologists, is
appropriate in selected cases.
Autopsy Report
There are several parts that should be included in a forensic autopsy report. To an
extent, some variation can exist from one office to the next, but all of the features