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PS-18-001
Causes of death in patients with lung cancer
T. Vasiljevic
*
, Z. Eri, D. Tegeltija, G. Samardzija
*
Oncology Institute of Vojvodin, Pathology, Sremska Kamenica, Serbia
Objective:
To determine causes of death in patients with lung cancer.
Method:
Retrospective study was performed on autopsy report
data from 213 patients with lung cancer who died in Institute of
lung diseases of Vojvodina in period from 1962 to 1975.
Results:
During 14 years period 1483 autopsies were performed,
213 in patients with lung carcinoma. Mean age in deceased with
lung cancer is 58,7 (range 24 to 85 years), predominantly males
(83 %) over females (17 %). Types of lung cancer were
reclassified as small cell carcinoma in 32 cases (15,1 %) and
non-small cell carcinoma in 191 cases (84,9 %). Two patients
had syncronous cancer (colorectal carcinoma and squamous cell
carcinoma of epiglottis with non-small cell carcinoma of the
lung). Most frequent causes of death in patients with lung cancer
are infection (25,8 %), tumour burden including metastatic cancer
disease (18,8 %) and pulmonary thromboembolism (17,8 %).
Infection includes acute bronchopneumonia in 46 cases, tubercu-
losis and pleuritis in 3 cases each. The following causes of death
are hemorrhage (13,1 %), cachexia (12,2 %), cardial causes
(6,1 %) and other causes including aspiration of stomach content
and bowel obstruction (3,7 %).
Conclusion:
Patients with lung cancer are prone to infection and
pulmonary embolism and it poses a challenge for prevention in
the future.
PS-18-002
Validity of a minimally invasive autopsy tool for cause of death de-
termination in paediatric deaths from Sub-Saharan Africa
N. Rakislova
*
, P. Castillo, M. R. Ismail, C. Carrilho, M. J. Martínez, L.
Quintó, Q. Bassat, C. Menéndez, J. Ordi
*
Hospital Clinic Barcelona, Dept. of Pathology, Spain
Objective:
Our knowledge of what is killing children in low in-
come countries remains poor, partly because of the inadequacy
and reduced precision of the methods utilized.The minimally in-
vasive autopsy (MIA) has been proposed as a substitute to the
complete autopsy (CA) in poor settings. We assessed the validity
of the MIA in determining the cause of death in 54 post-neonatal
paediatric deaths in a hospital of Mozambique by comparing the
results with those of the CA.
Method:
Concordance between the categories of diseases obtained
by the two methods was evaluated by the Kappa statistic and the
sensitivity, specificity, positive and negative predictive values of
the MIA diagnoses were calculated.
Results:
A cause of death was identified in all cases in the CA and in
96.3 % of the cases in the MIA, with infections and malignant tumours
accounting for the majority of diagnoses.The MIA showed a substantial
concordance with the CA (Kappa = 0.70;p-value < 0.0001) and sensitiv-
ity, specificity and overall accuracy were high.The ICD-10 diagnoses
were coincident in up to 75 %.The MIA allowed the identification of
the pathogens in 78.1 % of infection-related deaths.
Conclusion:
The MIA showed a substantial performance for cause of
death identification in this series and could provide robust data for CoD
surveillance in resource-limited settings.
PS-18-003
Analysis of postmortal diagnoses of patients died on the Institute for
Pulmonary Diseases of Vojvodina during the 10 years period
T. Lakic
*
, M. Panjkovic, A. Lovrenski, T. Ivkovic-Kapicl, J. Ilic-Sabo
*
Clinical Center of Vojvodina, Dept. of Pathology and Histology, Novi
Sad, Serbia
Objective:
Analysis of sex and age of patient died at the Institute for
Pulmonary Diseases of Vojvodina (IPDV) during a period of 10 years, as
well as their primary disease, the cause of death, length of hospital days.
Method:
We analyzed the autopsy records of all patients who underwent
clinical autopsy in the period 2005
–
2015. The pathological diagnoses
were grouped into 7 groups of diseases according to the International
Classification of Diseases, 10th Edition. At the end Goldman
’
s classifi-
cation was used.
Results:
It was autopsied total of 566 patients, average age 65.3 years,
whereby 68.5 % were men. The most of the patients have died at the
Urgent Pulmology Clinic (33 %), during the first 24 hrs of hospital ad-
missions, in 37.8 % patients malignant primary disease was found and the
most common cause of death was pneumonia (24.2 %). According to
Goldman
’
s classification the most of the analyzed autopsies showed full
confirmation of clinical diagnosis- Class V (49.8 %), while Class IV was
found in 9.2 %, Class III in 8.1 %, Class II in 17.1 % and Class I in 15.7 %
of autopsied patients.
Conclusion:
The autopsy is instrument for quality control, precise deter-
mination of the death cause, confirmation or correction premortal diag-
nosis and identification of new disease.
PS-18-004
An autopsy case of massive pulmonary tumour embolism due to
undiagnosed prostatic adenocarcinoma
T. Lakic
*
, A. Lovrenski, D. Skrbic, M. Panjkovic, V. Zecev
*
Clinical Center of Vojvodina, Dept. of Pathology and Histology, Novi
Sad, Serbia
Objective:
To present a case of massive pulmonary tumour embolism
due to undiagnosed prostatic adenocarcinoma.
Method:
We report an autopsy case in which hematoxylin and eosin as
well as immunohistochemical staining with prostate-specific antigen
(PSA) showed multiple tumour emboli within small and medium sized
pulmonary arteries.
Results:
A 78-year-old man without remarkable medical history was
admitted to our hospital with clinical symptoms suggestive of sub-
acute pulmonary thromboembolism. He suffered from progressive
dyspnea and general fatigue few days before admission and died
after 5 hrs of hospitalization. Due to unknown cause of death autop-
sy was performed. On autopsy, enlargement of prostate was found
and pathohistologically diagnosis of poorly differentiated adenocarci-
noma with Gleason
’
s score of nine was set. No metastasis in regional
lymph nodes and bones were found. In all specimens taken from
lungs multiple tumour emboli within small and medium sized pul-
monary arteries were found. Tumour emboli were composed of atyp-
ical polygonal cells with slightly enlarged nuclei and prominent nu-
cleoli which was arranged in small acinar and cribriform formations.
Immunohistochemical analysis with PSA staining showed diffuse and
strong positivity of tumour cells within pulmonary arteries.
Conclusion:
A prostate adenocarcinoma can extremely rarely be a cause
of massive pulmonary tumour embolism.
PS-18-005
Histopathological heart changes in autopsies of heroin abusers
I. Aleksic
*
, J. Dzambas, N. Marinkovic
*
Military Medical Academy, Institute of Pathology, Belgrade, Serbia
Wednesday, 6 September 2017, 09:30
–
10:30, Hall 3
PS-18 Autopsy Pathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S233