AUTOPSY REPORT

GROSS AND MICROSCOPIC DESCRIPTION

GROSS EXAMINATION The body is that of a 64-year-old male. The body was opened by means of a
midline incision showing the pleural and peritoneal cavities. The organs were removed en toto by the
Rokitansky method.

CARDIOVASCULAR SYSTEM: The pericardial cavity contains minimal amount of clear fluid. The heart
appears enlarged and measures 13.0 x 10.0 x 8.0 cms and weighs 480.0 grams. Cut sections show a
thickened left ventricular wall measuring 2.5cm, with a focus of reddish area in the anterior ventricular
wall, surrounded by white, firm tissues and cardiac muscles. Coronary arteries show evidence of
calcification. Microsections show edema, hemorrhage, infiltrates of neutrophils and mottling of the
cardiac myocytes. Other areas of show bands of fibrotic tissues traversing the cardiac myocytes.
Coronary arteries are atherosclerotic.

RESPIRATORY SYSTEM: The lungs are reddish black and spongy. The right lung measures 22.0 x 11.0 x
8.5 and and weighing 300.0 grams while the left lung measures 23.0 x 12.5 x 7.5 and weighing 275
grams. Cut sections show moderate amount of mucoid material within the airway lumen. There are no
gross masses noted. Microscopic sections of both lungs show carbon dusts and hemosiderin-laden
macrophages noted amidst pools of edema fluid, blood and congested vascular channels. Dilated alveoli
with damage alveolar walls are also seen. No evidence of malignancy noted.

LIVER: The liver is enlarged, yellowish-brown, smooth, which measures 27.0 cm x 24.5 cm x 14.0 cm
and weighing 2100.0 grams. Cut sections show yellowish-brown, greasy surface. Microsections of the
liver show sheets of hepatocytes arranged in single-cell thick plates separated by vascular sinusoids
filled with red blood cells. These hepatocytes exhibit lipid vacuoles within the cytoplasm. There are
patches of lymphocytic infiltrate and foci of hepatocellular necrosis around the central veins.

SPLEEN: The spleen is fairly ovoid, bluish, doughy tissue measuring 11.0 cm x 10.0 cm x 4.0 cm and
weighs 180 grams. Cut sections reveal a fairly solid reddish-brown cut surface. Microsections show
spleen show well-delineated red pulp and white pulp with congested splenic cords filled with red cells.

PANCREAS: The pancreas presents as an elongated to ovoid, broad, tan to yellow tissue with fairly
smooth surface measuring 21.0 x 5.0 x 3.5 cms and weighing 115. grams. Cut sections show a yellowish-
tan, lobulated surface. Microsection show acinar glands in lobular architecture and interrupted by islets
of Langerhans. Vascular congestion is also seen.

KIDNEYS: The right and left kidneys are covered by abundant perinephric fat and measure 10.7 x 5.0 x
3.5 cms, and 11.0 x 6.5 x 5.5 cm, respectively. Cut sections reveal a reddish brown solid parenchyma
with prominent cortico-medullary junction. The pelvocalyceal system is intact. Microsections of both
kidneys and the pelvocalyceal system show essentially normal findings. Vascular congestion is also seen.

GASTROINTESTINAL SYSTEM The stomach measures 22.0 x 14.0 x 6.5 cms. The mucosa appears light
tan with prominent rugal folds and containing brown fluid amounting to 150.0 ml. There is no ulceration
or mass noted. The small intestine consists of a pinkish tan light tan tissue with smooth serosa. Likewise
the colon measures 220 x 8.0cm, and show unremarkable gross findings. The appendix is absent.
Microsections of the gastrointestinal tract show intact mucosa with focal patches of lymphocytic
infiltrates.
ORGAN GROSS MICROSCOPIC ANATOMICAL DX

CARDIOVAS ● pericardial cavity ● edema, Cardiomegaly- heart weighs 480 grams but
CULAR contains minimal hemorrhage, normally 300-360 grams kapag male.
SYSTEM amount of clear infiltrates of
fluid neutrophils
and mottling Coronary arteries are atherosclerotic:
● heart appears of the cardiac Atherosclerosis - probably secondary to his DM
enlarged and myocytes
measures 13.0 x
10.0 x 8.0 cms ● bands of
and weighs 480.0 fibrotic tissues Coronary Arteries Occlusion- MI
grams traversing the
cardiac
● thickened left myocytes Edema, hemorrhage, infiltrates of neutrophils and
ventricular wall mottling of the cardiac myocytes - Myocardial
measuring 2.5cm infarcts (Early in an infarct, it is hypereosinophilia of
● Coronary arteries myocytes, usually accompanied by contraction
show evidence of bands and loss of myocyte nuclei. The next to
calcification appear is the interstitial inflammatory cell infiltrate.
Neutrophils arrive first and are the hallmark of early
● Coronary arteries ischemia, defined as the first 72 hours. They are
are initially seen in perivascular spaces as they
atherosclerotic marginate through blood vessels.)

Mottling of the cardiac myocytes- Neurocardiogenic

Injury (Takotsubo cardiomyopathy)

RESPIRATO ● lungs are reddish ● carbon dusts ● lungs are reddish black and spongy - patient is
RY SYSTEM black and spongy and a smoker
hemosiderin-
● moderate laden ● carbon dusts and hemosiderin-laden
amount of macrophages macrophages noted amidst pools of edema
mucoid material noted amidst fluid, blood and congested vascular channels-
within the airway pools of Hemodynamic pulmonary edema
lumen edema fluid, ● Dilated alveoli with damage alveolar walls -
● no gross masses blood and Emphysema (Emphysema can lead to
noted congested destruction of the alveoli, the tiny air sacs that
vascular allow oxygen to get into the blood. Their
channels destruction leads to the formation of large air
● Dilated alveoli pockets in the lung called bullae. These
with damage bullae do not exchange oxygen and carbon
alveolar walls dioxide like normal lung tissue. Also, the bullae
can become very large.) Pulmonary
emphysema is defined as abnormal
permanent enlargement of air spaces distal to
the terminal bronchioles, accompanied by
 destruction of bronchiolar walls.

LIVER ● enlarged, ● sheets of ● hepatocytes exhibit lipid vacuoles within the

yellowish-brown, hepatocytes cytoplasm - macrovesicular
smooth, which arranged in steatosis (Macrovesicular steatosis is the
measures 27.0 single-cell most common form and is histologically
cm x 24.5 cm x thick plates characterized by hepatocytes containing a
14.0 cm and separated by single vacuole of fat filling up the hepatocyte
weighing 2100.0 vascular and displacing the nucleus to the cell's
grams sinusoids filled periphery. Macrovesicular steatosis is
with red blood typically caused by alcohol, diabetes, or
● yellowish-brown, cells obesity.) Liver Cirrhosis
greasy surface
● hepatocytes
exhibit lipid
vacuoles
within the
cytoplasm

● patches of
lymphocytic
infiltrate and
foci of
hepatocellular
necrosis
around the
central veins

SPLEEN ● fairly ovoid, ● spleen show In general, an adult spleen is about 5 inches long, 3
bluish, doughy well- inches wide, 1.5 inches thick, and weighs about 6
tissue measuring delineated red ounces
11.0 cm x 10.0 pulp and white
Splenomegaly
cm x 4.0 cm and pulp with
weighs 180 congested ● congested splenic cords filled with red cells-
grams splenic cords Congestion of the spleen is characterized by
filled with red excessive distension of sinuses within the red
● yellowish-tan, cells pulp by erythrocytes . Splenic congestion is
lobulated surface
common, although a cause is not always
apparent.

PANCREAS ● elongated to ● acinar glands Pancreatitis?

ovoid, broad, tan in lobular
to yellow tissue architecture
with fairly and
smooth surface interrupted by
measuring 21.0 x islets of
5.0 x 3.5 cms and Langerhans
weighing 115.
● Vascular
 grams congestion

● yellowish-tan,
lobulated surface

KIDNEYS ● abundant ● kidneys and Congestion of the kidneys due to heart failure
perinephric fat the
and measure pelvocalyceal
10.7 x 5.0 x 3.5 system show
cms, and 11.0 x essentially
6.5 x 5.5 cm normal
findings
● Reddish brown
solid parenchyma ● Vascular
with prominent congestion
cortico-medullary
junction.

● pelvocalyceal
system is intact.

GASTROINT ● The mucosa ● mucosa with Mucosa with focal patches of lymphocytic
ESTINAL appears light tan focal patches infiltrates.- Nodular lymphoid hyperplasia of the
SYSTEM with prominent of lymphocytic gastrointestinal tract is characterized by the
rugal folds and infiltrates. presence of multiple small nodules, normally
containing brown between between 2 and 10 mm in diameter,
fluid amounting distributed along the small intestine (more often),
to 150.0 ml stomach, large intestine, or rectum. The
pathogenesis is largely unknown. It can occur in all
● no ulceration or age groups, but primarily in children and can affect
mass noted adults with or without immunodeficiency
● small intestine
consists of a
pinkish tan light
tan tissue with
smooth serosa

● colon measures
220 x 8.0cm, and
show
unremarkable
gross findings

● appendix is
absent

● Category I : Disease causing death directly : Acute Myocardial Infarction

●  Category II: Disease/s contributing or related to death by cause or effect : Atherosclerosis,
Emphysema
● Category III: Significant disease/s not related to death but significant enough to contribute to the
death of the patient: Hemodynamic pulmonary edema
● Category IV: Incidental disease/s : Pancreatitis, Steatosis, Liver and Splenic Congestion
● Category V: Anatomic cause of death : Acute Myocardial Infarction secondary to Atherosclerosis
and Emphysema????