HISTOLOGY AND HISTOPATHOLOGY

Cellular and Molecular Biology

 

Histological findings and immunohistochemical surfactant protein A (SP-A) expression in asphyxia: Its application in the diagnosis of drowning

M.D. Pérez-Cárceles1, A. Sibón2, M.A. Vizcaya2, E. Osuna1, M. Gómez-Zapata1, A. Luna1 and F. Martínez-Díaz 3

1Department of Legal and Forensic Medicine, University of Murcia, Spain, 2Department of Legal and Forensic Medicine, University of Cádiz, Spain and 3Department of Pathology, University of Murcia, Spain.

Offprint requests to: Assistant Professor M.D. Pérez-Cárceles, Department of Legal and Forensic Medicine, School of Medicine, University of Murcia, E-30100 Espinardo, Murcia, Spain. e-mail: mdperez@um.es


Summary. The histopathological alterations that permit the diagnosis of death by asphyxia are very unspecific, although pulmonary alterations are of great importance in this respect. The postmortem diagnosis of drowning, particularly, continues to be one of the most difficult in forensic pathology. The aim of this study is to jointly evaluate microscopic findings and immunohistochemical surfactant protein A (SP-A) expression in the upper and lower lobes of lungs in different causes of death, and their possible application to the diagnosis of drowning. We studied 120 cadavers from subjects with a mean age of 48.73 years (SD 19.45; range 2-86 years), and with a mean post-mortem interval of 30 hours (SD 39.59; range 3-216 hours). According to the scene, cause and circumstances of death, and autopsy findings, cases were classified into groups as follows: (a) drowning (n=47); (b) other asphyxia (n=44) and (c) other causes (n=29). In the upper and lower lobes of lungs, histological studies of H&E staining and immunohistochemical surfactant protein A expression were made. The presence and severity of congestion, haemorrhage and oedema, together with immunohistochemical SP-A expression, may have a diagnostic value in differentiating asphyxia and drowning from other causes of death, and drowning from other types of asphyxia. Our findings suggest that both lobes should be investigated to establish the diagnosis, although the findings in the upper lobe might be the most important for differentiating the exact cause of death. Histol Histopathol 23, 1061-1068 (2008)

Key words: Forensic Pathology, Asphyxia, Surfactant protein A, Lungs

DOI: 10.14670/HH-23.1061