Autopsy Practices Dhaneshwar Lanjewar, Pradeep Vaideeswar
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ge1AUTOPSY PRACTICESge2
ge3AUTOPSY PRACTICES
Editors Dhaneshwar Lanjewar MD (Pathology) DCP Professor Department of Pathology Grant Government Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals Mumbai, Maharashtra, India Pradeep Vaideeswar MD Professor (Additional) Department of Pathology Seth Gordhandas Sunderdas Medical College Mumbai, Maharashtra, India Foreword Professor Ulhas Wagholikar
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Autopsy Practices
First Edition: 2017
9789386056160
Printed at
ge5Dedicated to
To all those cadavers on whom clinical autopsies were performed, due to which our understanding of diseases has improvedge6
ge7Contributors
  • Anjali Amrapurkar
  • Professor
  • Department of Pathology
  • Lokmanya Tilak Memorial Medical College
  • Mumbai, Maharashtra, India
  • Arvind Valand
  • Professor and Head
  • Department of Pathology
  • Swami Ramanand Teerth Rural Government Medical College
  • Ambajogai, Maharashtra, India
  • Ashim Das
  • Professor
  • Department of Histopathology
  • Postgraduate Institute of Medical Education and Research
  • Chandigarh, India
  • Bhuvaneshwari Kandalkar
  • Former Professor and Head
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • Bishan Radotra
  • Professor
  • Department of Histopathology
  • Postgraduate Institute of Medical Education and Research
  • Chandigarh, India
  • Daksha Prabhat
  • Professor
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • Deepak Joshi
  • Professor and Head
  • Department of Anatomy
  • Grant Government Medical College
  • Mumbai, Maharashtra, India
  • Dhaneshwar Lanjewar
  • Professor
  • Department of Pathology
  • Grant Government Medical College and
  • Sir Jamshedjee Jeejeebhoy Group of Hospitals
  • Mumbai, Maharashtra, India
  • Gayathri Amonkar
  • Associate Professor
  • Department of Pathology
  • Topiwala National Medical College
  • Mumbai, Maharashtra, India
  • Jaya Deshpande
  • Former Professor and Head
  • Department of Pathology
  • Topiwala National Medical College
  • Mumbai, Maharashtra, India
  • Kusum Jashnani
  • Additional Professor
  • Department of Pathology
  • Topiwala National Medical College
  • Mumbai, Maharashtra, India
  • Pradeep Vaideeswar
  • Professor (Additional)
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • Pragati Sathe
  • Associate Professor
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • Ratnaprabha Ghodke
  • Assistant Professor
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • ge8Shailesh Mohite
  • Professor and Head
  • Department of Forensic Medicine
  • Topiwala National Medical College
  • Mumbai, Maharashtra, India
  • Smita Divate
  • Professor (Additional)
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • Subhash Yadav
  • Assistant Professor
  • Department of Pathology
  • Seth Gordhandas Sunderdas Medical College
  • Mumbai, Maharashtra, India
  • Vinaya Shah
  • Professor (Additional)
  • Department of Pathology
  • Hinduhridaysamrat Balasaheb Thackeray
  • Medical College and Dr RN Cooper Municipal General Hospital
  • Mumbai, Maharashtra, India
ge9Foreword
I had the privilege of working for 35 years (1958–93) in the Pathology School, Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, Maharashtra, India, where, on an average, 1,500 clinical and 9,000 medicolegal autopsies used to be conducted per year, since 1930s. Generation after generation of dedicated teachers (Professors Raghavendra Rao, VR Khanolkar, PV Gharpure, HI Jhala, RK Gadgil and MM Rananavare) had this rich experience of autopsy pathology, which they had converted into expertise. Every new resident, entering the department, had the advantage of being backed by this expertise and a chance to develop his own. I still remember being taught, on the spot and by hand-to-hand training, by the seniors in the department: how to conduct autopsies, modify and innovate the standard procedures in view of some unusual clinical features of the case, collect material for further investigations, keep records, preserve and document important lesions and correlate the clinical findings with conclusions of the autopsy.
Daily, at 12 noon, we had departmental death conferences, wherein all the autopsies, conducted by residents and lecturers, in the previous 24 hours, were reviewed by the senior teacher-in-charge of autopsy section. Once a week, there would be interdepartmental clinicopathological conferences (CPC) with clinicians on selected cases. Academically, important aspects of the case would be discussed to the benefit of all (clinicians, pathologists and undergraduate as well as postgraduate students). The CPCs were rich experiences in all-round medical teaching and learning, for all.
As I look back, I can say, with conviction, that, this was more or less so, not only in our department but also in the major centers of medical education in the country including Chandigarh, Chennai, New Delhi, Kolkata, Lucknow, Vellore, Visakhapatnam, etc. Less developed centers, where autopsies were not done in large numbers, used to depute, regularly, their staff members to the major centers for training and experience in autopsies.
It is unfortunate that in the past two and half decades, the scenario has changed; and the trend is rapidly progressing, universally, because of reduction in the number of autopsies. There are medical colleges where no autopsies are conducted. The number of senior teachers with experience in autopsy pathology is getting drastically reduced, day-by-day. Not in very distant future, a situation may be experienced that a professor of pathology has seen a myocardial infarct only in the museum jar of his/her department. At this juncture, a book on autopsy pathology is very welcome.
ge10When there is scarcity of medical teachers, with adequate experience of conducting autopsies, any new entrant in the field will have to depend on “texted” source of knowledge. This book meets his/her need. At this point of time, we still have senior teachers, with vast experience and carefully cultivated proficiency in the field of autopsy pathology. It is good to note that the book has been contributed by stalwarts carefully selected from different prominent centers of the country and that they have done justice to the task. Users of the book will realize the truth behind the quote: Pathology can be taught but cannot be learnt without autopsies.
Professor Ulhas Wagholikar MD FICP
Retired Professor and Head
Department of Pathology
Grant Government Medical College and
Sir Jamshedjee Jeejeebhoy Group of Hospitals
Mumbai, Maharashtra, India
Past President
IAPM (1992)
ge11Preface
The traditionally recognized contributions of the autopsy such as its role in defining new disease entities, in the quality control of patient care and in determining the cause of death, are just as relevant today as in the past. The progress of pathology in India began in 1840, and in those days, the roots of development of pathology in India were in the premier institutes. Significant contributions on neuropathology, cardiovascular and pulmonary pathology, and AIDS pathology were made from medical colleges in Mumbai; this work is known throughout the globe.
Currently, there is no autopsy book authored by Indian pathologists describing procedural details of performing autopsy. Autopsy Practices is a contribution by several pathologists from Mumbai and Chandigarh, and each author has performed and/or observed several thousand clinical autopsies. All the topics are written in conventional pattern and each topic is designed to offer practical guidelines that will lead pathologists to identify, interpret and correlate the autopsy findings. In addition, a topic on “Autopsy and Law” will be useful for the postgraduates in Forensic Medicine and Toxicology.
It is hoped that this first edition with its emphasis on practical procedures will be of assistance to the pathologists of developing and developed countries.
Dhaneshwar Lanjewar
Pradeep Vaideeswarge12ge13ge14ge15