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Approccio istologico sperimentale con soluzione reidratante di Sandison a tessuti cadaverici carbonizzati
Full text linkFor a forensic pathologist, the autopsy of a charred body represents a scenario that is difficult to handle from several points of view: identification of the victim, chronological determination of the injuries observed, and definition of the dynamics of the event to distinguish whether it is an accident, a suicide, or a homicide/cadaveric destruction. In fact, charring leads to darkening and desiccation of the skin with possible deep lacerations; moreover, when it affects deep tissues, it can cause injuries and a reduction in the volume of internal organs due to desiccation and the expansion of intracavitary gases. In this context, microscopic examination is particularly challenging, not only because fragile, disintegrated, and extremely dry tissues can be easily lost in standard histological examination procedures, but also because the few sections obtained have many technical artefacts. Since the use of various rehydration solutions has been shown to be effective in improving the histological examination of mummified and corified skin specimens, we experimentally applied Sandison's rehydration solution to skin and visceral samples from charred cadavers. Histological specimens observed after hematoxylin-eosin and Masson-Goldner trichrome staining showed qualitatively better morpho-structural aspects compared to those obtained with routine formalin fixation. In parenchymatous viscera, Sandison’s solution partially eliminated the changes caused by severe carbonization with a discrete improvement, while in hollow organs it caused a moderate regeneration of histological structures. Sandison’s solution was particularly effective in skin, brain, and aorta specimens; it caused partial histomorphological recovery of dura mater, esophagus, lung, heart, liver, and kidney. However, spleen and small intestine specimens, in which signs of heat protein coagulation, coarctations, and foci of nuclear pyknosis persisted, were not significantly improved. In addition, the use of Sandison’s solution resulted in a partial recovery of the affinity of the connective tissue dye for trichrome staining: in charred skin specimens not pretreated with rehydration solution, a paradoxal staining of the connective tissue was observed, which appeared red instead of green. This phenomenon, although little known, is reported in the literature and can be fully explained by the extreme destructive power of hyperthermic lesions, which, due to the severe dehydration of the tissue, as in the case of charring, denature the protein structures, leading to conformational changes in the microstructure of collagen and changes in the penetration capacity of dyes in the affected tissues. Sandison's rehydration solution, on the other hand, thanks to an emulsifier - sodium carbonate Na2CO3 - is able to penetrate deeply and homogeneously into the cadaveric tissue and, thanks to a solvent - 96% ethanol - stabilizes the tissue so that it does not collapse and the impaired structures are restored, ensuring better stainability [5]. Thus, overall, the Sandison rehydration procedure is useful and effective and results in high-quality histological sections with less destructive thermal effects, although complete recovery is not always possible. In view of these results, we recommend the use of this procedure in the histological examination of charred skin and viscera specimens
Letter to the Editor regarding the article "Mummification in a forensic context: an observational study of taphonomic changes and the post‐mortem interval in an indoor setting"
No full textPilot Application of SEM/EDX Analysis on Suspected Cigarette Burns in a Forensic Autopsy Case of Child Abuse
Full text linkCigarette burn lesions present forensic scenarios that are often difficult to investigate, both from a morphological diagnostic point of view and with regard to the mode of infliction, especially if the victim is unable to speak or has died. Although there may be the suspicion for a lesion to be produced by a lit cigarette, to date one can only rely on the morphological aspects that characterize it, and there is a lack of tools to reach the most evidence-based diagnosis possible. This limitation arose when managing a forensic autopsy case of possible child abuse that resulted in the death of the child, characterized by the presence of 3 suspicious cigarette burn lesions. We therefore decided to perform scanning electron microscopy/energy-dispersive x-ray (SEM/EDX) spectrometry analysis on these lesions and on the cigarette butt found at the crime scene. At the same time, SEM/EDX was applied to the analysis of an unlit cigarette in its entirety (obtained from the same source package as the cigarette butt), a positive control skin sample with an iatrogenic cigarette burn injury, and a negative control skin sample. Among the various compounds highlighted on compositional analysis, only sulfuric anhydride (SO 3 ) and phosphoric anhydride (P 2 O 5 ) showed a highly significant distribution pattern by being found in the autopsy samples, the cigarette butt, the tobacco of the unlit cigarette, and the positive skin control. Considering this, cigarette burns appear to follow Locard's principle as well, and similarly to other lesions, SEM/EDX allowed the diagnosis of cigarette burn lesions, already suspected morphologically, to be corroborated. Therefore, SEM/EDX is confirmed as a helpful tool in forensic pathology investigations
Uterine leiomyosarcoma as a rare cause of fatal retroperitoneal haemorrhage due to compression and rupture of the renal vein
Full text linkAbnormal uterine bleeding (AUB) can be caused by uterine tumors, both benign and malignant, although they rarely lead to fatal vascular complications. We present a case of a woman found dead in her home, in which the autopsy highlighted a massive retroperitoneal haemorrhage extending to the left renal lodge and a voluminous uterine tumor of stony consistency and exophytic growth weighing 2250g. The histopathological examination identified the mass as a leiomyosarcoma and demonstrated the presence of a dilation with rupture of the left renal vein, in the absence of neoplastic cells infiltrating the vascular wall. On these findings, it was concluded that the neoplastic mass had caused external compression of the left renal vein, leading to its rupture and to a fatal retroperitoneal haemorrhage. The case was considered of interest as it involved a peculiar etiopathogenetic mechanism causing a lethal complication from uterine leiomyosarcoma which has not yet been reported in the literature
A narrative review of peculiar forensic-pathological applications of scanning electron microscopy with energy dispersive X-ray analysis (SEM/EDX)
No full textThe application of scanning electron microscopy with energy dispersive X-ray analysis (SEM/EDX) to the main types of
injuries from a forensic point of view, such as blunt force trauma, ligature strangulation, electricity, sharp force trauma,
gunshot wounds, and chemical injuries, is a well-known topic that has been extensively discussed in the literature. However, the use of SEM-EDX is not limited to the above-mentioned cases, and its extreme versatility leads to the successful
application of this technique in other forensic contexts. For this reason, all of the particular applications that have been
reported in the literature to date are presented and discussed in this narrative review. Indeed, there are several underresearched forensic areas and unusual pathological scenarios in which this technique can be used and could prove to be
crucial. Therefore, our goal is twofold: to highlight the versatility of SEM-EDX analysis in the forensic field and to provide the scientific community with a unique document reporting all possible forensic pathological applications that have
been investigated to date, including unusual and solitary ones, in order to provide a procedural vademecum when needed
Can skin histology be a useful tool for ancestry assessment in forensic settings? Ancestry assessment based on melanin pigment
No full textBuilding the biological profile of a deceased person represents a pivotal step in order to achieve the victim's identification. Specifically with regard to ancestry, the melanin distribution pattern in the dermal-epidermal layers has been poorly explored in the forensic field as a potential useful tool. In particular, nothing has been reported about the reliability of such method in bodies in active decay or in advanced state of decomposition. In this study fragments of skin sampled from bodies of known ancestry, both in good and in poor states of preservation, were subjected to histological analysis. We selected 15 subjects, which were divided into three groups: group A (5 white Europeans), group B (5 black Africans) and group C (5 Orientals). A double skin sample was performed on all the bodies, one from the abdomen and the other one from the right forearm. After histological processing and staining with hematoxylin and eosin (H&E) and Masson-Hamperl trichrome technique, the cutaneous melanin distribution pattern was assessed using a semi-quantitative score. The melanin distribution patterns observed both in fresh and in putrefied cadaveric skin were found to be in all cases consistent with the victims’ known ancestry. Moreover no differences were observed between abdominal and forearm skin samples and all the histological findings highlighted by H&E were confirmed by the Masson-Hamperl trichrome staining. We demonstrated that the histological analysis aimed at assessing the melanin distribution pattern may be a valuable useful tool in the assessment of ancestry
Post-Mortem Diagnosis of a Rare Case of Massive Nodular Pulmonary Amyloidosis in a Forensic Setting
No full textMechanical asphyxia by hanging and gunshot to the head: A series of rare planned complex suicides
No full textA suicide where the deceased has employed more than one means of ending his or her life is defined as a complex
suicide (CS). Forensic practitioners may face difficulties caused by the articulated mechanisms underlying this event.
Among CS, the combination of hanging and gunshots is unusual. In this study, we present three unique cases of such
planned complex suicides (PCS) that we have encountered in our 28 years of activity at the Bureau of Legal Medicine of
Milan. Careful inspection of the death scene, precise analysis of the anamnestic-circumstantial data, and accurate
medico-legal autopsy examination were the starting points for a better understanding of the causes and manner of
death. In particular, the presence of vital reactions of tissues involved in the two different means used, the coherence of
the areas involved with a self-inflicted wound, and the absence of signs of third party intervention allowed us to classify
these events as suicides. As for the chronology of events, the lethality of the cerebral lesions caused by the gunshots in
all cases, in accordance with the cervical lesions caused by hanging, led us to conclude that we were dealing with PCS and
catalogue these three cases as unusually planned complex suicides avoiding incorrect and superficial classification
Colorimetric Barium Detection of Gunshot Residues on Cadaveric Human Skin: A Pilot Application for Forensic Purposes
No full textIn this study we microscopically investigated, for the first time ever, the colorimetric detectability of barium of gunshot
residues (GSR) on cadaveric human skin with gunshot wounds. Methods: For this purpose we used two different colorimetric techniques
known in the literature, namely 0.2% sodium rhodizonate (Na-R-Ba 0.2%) and sodium rhodizonate in alcoholic environment (Na-R-Ba OH
0.2%). At the same time, we have also coupled it with scanning electron microscopy with energy dispersive X-ray (SEM/EDX) analysis and
the colorimetric study for the detection of lead of GSR. These techniques were applied to 16 victims who died from gunshot injuries, as well
as to a control group. Results: SEM/EDX demonstrated the presence of lead in all cases and barium in 11 of the 16 cases. The subsequent
colorimetric technique with Na-R-Ba 0.2% did not show the barium of GSR in any case, unlike the Na-R-Ba OH 0.2% technique. This
latter, in fact, has demonstrated the presence of this metal in 2 cases (18%). No microscopic case of false positive was recorded.
Conclusion: The evidence obtained with Na-R-Ba OH 0.2% makes this method, applied here for the first time ever, worthy of further study.
Meanwhile, although this technique can certainly be applied, it cannot be separated from the contextual colorimetric investigation for lead
and the use of more sophisticated techniques
Macroscopic and microscopic features in a fatal case of hypertrophic obstructive cardiomyopathy after myectomy
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