{"id":1762,"date":"2024-03-23T11:09:13","date_gmt":"2024-03-23T15:09:13","guid":{"rendered":"http:\/\/wordpress.forensicpath.us\/?p=1762"},"modified":"2024-03-23T11:09:13","modified_gmt":"2024-03-23T15:09:13","slug":"pathology-cases-hepatic-cyst","status":"publish","type":"post","link":"https:\/\/wordpress.forensicpath.us\/index.php\/2024\/03\/23\/pathology-cases-hepatic-cyst\/","title":{"rendered":"Pathology cases- hepatic cyst"},"content":{"rendered":"

The decedent was a 70 year old man with obesity, diabetes mellitus type II, history of\u00a0 heavy tobacco use who complained of shortness of breath.\u00a0 He went to a local clinic and was reported to have a positive covid-19 result.\u00a0 The next day he suffered a witnessed collapse and died.\u00a0 At autopsy, he had severe multivessel atherosclerotic disease of his coronary arteries and cerebrovascular system as well as severe aortic arteriosclerosis.\u00a0 Examination of the lungs revealed moderate pulmonary fibrosis, chronic bronchitis, and acute pulmonary edema with hemorrhage.\u00a0 An interstitial pneumonitis was not present, nor was there acute pneumonia.\u00a0 I concluded that the decedent’s death was primarily due to his cardiovascular disease.\u00a0 His rapid covid test may or may not have been a false positive, but if it was positive, it represented a stressor and cardiac trigger.<\/p>\n

As an incidental finding, there was a 15 cm thick walled cyst adherent to the liver, containing necrotic debris:<\/p>\n

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On histology, the wall consisted of a thick fibrous paucicellular wall with focal acute intramural hemorrhage.\u00a0 There was no discernible epithelial lining (though these usually have low cuboidal epithelium).\u00a0 Subjacent to the cyst at the point of attachment, there were thick-walled arteries and veins with prominent nervous tissue.\u00a0 The obligatory chronic inflammation was also present.<\/p>\n

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The hepatic\/perihepatic cysts are usually old pancreatic pseudocysts.\u00a0 This decedent had no history of pancreatisis, and the sections I took looked fine (as far as postmortem autolyzed pancreases go).\u00a0 You can sometimes get them with biliary obstruction, though those are usually deeper, from my reading.\u00a0 They usually contain clear fluid, not the necrotic debris seen here.\u00a0 When I reviewed the decedent’s medical history following the autopsy (I usually don’t get records until a day or so after the postmortem examination), it turned out that this had been incidentally discovered some years ago on CT scan for another issue.\u00a0 His docs wanted to drain it, but he was not enthusiastic.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

The decedent was a 70 year old man with obesity, diabetes mellitus type II, history of\u00a0 heavy tobacco use who…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[99,108,109,60],"tags":[59,122,75,26,123],"class_list":["post-1762","post","type-post","status-publish","format-standard","hentry","category-forensic-pathology","category-gross-pathology","category-pathology-cases","category-photomicrographs","tag-autopsy","tag-cyst","tag-liver","tag-photomicrography","tag-pseudocyst"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1762","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=1762"}],"version-history":[{"count":1,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1762\/revisions"}],"predecessor-version":[{"id":1766,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1762\/revisions\/1766"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=1762"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=1762"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=1762"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}