Forensic Histopathology: Fundamentals and Perspectives PDF
Preview Forensic Histopathology: Fundamentals and Perspectives
Reinhard B. Dettmeyer Forensic HHiissttooppaatthhoollooggyy Fundamentals and Perspectives 123 Forensic Histopathology Reinhard B. Dettmeyer Forensic Histopathology Fundamentals and Perspectives Author Prof. Dr.Dr. Reinhard B. Dettmeyer Justus-Liebig-University Gießen Institute of Forensic Medicine Frankfurter Straße 58 D-35392 Gießen Germany [email protected] ISBN 978-3-642-20658-0 e-ISBN 978-3-642-20659-7 DOI 10.1007/978-3-642-20659-7 Springer Heidelberg Dordrecht London New York Library of Congress Control Number: 2011933846 © Springer-Verlag Berlin Heidelberg 2011 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcast- ing, reproduction on microfi l m or in any other way, and storage in data banks. Duplication of this publi- cation or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protec- tive laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Cover design: eStudioCalamar, Figueres/Berlin Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) To my family Foreword A review of the relevant specialist literature clearly demonstrates that no new works on forensic histopathology covering state-of-the-art knowledge and detection meth- ods have appeared in recent decades. The present book makes it convincingly clear that forensic histopathology as a specialist fi eld in its own right within forensic medicine has undergone an expansion in terms of its required application and, by adopting and applying modern methods of investigation, has gained in diagnostic importance. The 20 chapters of this book present the procedures and microscopic analyses available today for the investigation of almost all injury types seen in humans, includ- ing postmortem changes, supported to a great extent by excellent color images, as well as numerous tables and abundant references to the specialist literature. Particular attention has been paid to interesting and rare drug-, medication-, and other toxin-related histopathological fi ndings, to which a whole chapter has been devoted. The present book has striven in particular to provide the basics of forensic medi- cine, together with tips on application in everyday practice, as well as on recom- mended staining methods, e.g., when using immunohistochemical techniques. The knowledge presented here on histomorphological detection methods from a forensic perspective also has an af fi rmative signi fi cance in terms of application, in particular when investigating scienti fi c facts which could be used as evidence. In the future, expert opinions on human injury aiming to satisfy scienti fi c requirements should be inadmissible if histological fi ndings are not included. In terms of the administration of justice, the requirement for histological analysis in forensic practice can also be considered a guideline to ensure that minimum stan- dards are observed. The above, however, cannot be reconciled with the often excessively short time devoted to pathology during a normal forensic residency of only 6 months, a time period which precludes the possibility of suf fi cient training in microscopic techniques and fails to re fl ect the importance of histology. This obvious de fi cit needs to be redressed urgently.Seen as a whole, the present book represents a scienti fi c heavy- weight endowed with the best characteristics of a specialist textbook and designed to broaden forensic histological diagnosis while making it more reliable. The book will be a pleasure to read for any forensic pathologist with an interest in morphology. Summer 2011, Hamburg, Germany Werner Janssen vii Preface Since the publication of W. Janssens’ “Forensic Histology” more than a quarter of a century ago, no updated work going beyond a simple atlas on forensic histopathology and providing the basics, discussing perspectives, and taking new immunohistochem- ical methods into consideration has been published. At the same time, it must be noted that both forensic medical training and continuing medical education in the fi eld of forensic histology and histopathology, i.e., microscopy, are frequently insuf fi cient. There is often scant awareness of the potential offered by microscopic investigations to gain forensic insight on the one hand, while on the other, inappropri- ate staining methods are frequently chosen, staining artifacts are incorrectly inter- preted, disease patterns remain undetected or wrongly interpreted, or additional valuable immunohistochemical investigations are simply omitted. Particularly in forensic medicine, diagnostic questions are encountered which only histology or histopathology can help answer, e.g., when clarifying a cause of death, estimating the age of a wound or disease, detecting drug- and medication- induced fi ndings, or establishing important differential diagnoses, to mention but a few. It is very much to be desired that these de fi cits will be recognized and that microscopic diagnosis in forensic medicine will receive greater attention in the future. The present book is designed to provide a source of valuable information as well as a selection from the near unmanageable volume of relevant literature, while dis- cussing perspectives for further diagnostic options and scienti fi c studies. To this end, the most important aspects of forensic histopathology and cytological diagnosis are brought together and discussed – within the obvious constraints – over 20 chapters. Given the wide spectrum of diseases known to explain death by natural causes, a selection of frequently observed fi ndings are presented, making their relevance to general and special pathology evident. Important fi ndings relevant to a multitude of forensic questions are presented either in table form or in numerous microscopic images intended to serve as a guide to the reader’s own microscopy diagnostic procedures. It is the author’s hope that the potential offered by microscopy to gain insight into scienti fi c studies as well as in routine diagnostics will gain greater recognition. Such a move would not only serve the interests of the fi eld of forensic medicine and the responsible police, judicial, and court authorities, but also those of surviving relatives, for whom clarifying a cause of death can be an important consolation as well as a useful aid when enforcing legiti- mate claims. A complete description of additional and more detailed information on the signi fi cance of histopathological fi ndings and the use of immunohistochemical mark- ers relevant to many cases of forensic diagnosis is beyond the scope of this book. This ix
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