Lung weights and undiagnosed lung lesions in medico-legal autopsies in Dar es Salaam, Tanzania

Abstract Background Medico-legal or forensic autopsy is a special type of autopsy performed under the orders of a legal authority in circumstances involving unnatural, suspicious or criminal deaths. Gross and histopathological studies of viscera in medico-legal autopsies have been observed to serve as crucial tool in the detection of undiagnosed disease conditions and the resulting findings may closely represent the general population. Methods A prospective cross sectional study was carried out at the Muhimbili National Hospital (MNH) department of pathology, to medico-legal autopsies received at the MNH mortuary. The study included 103 cases in an eight month period. Both lungs were weighed for each case and tissue samples were collected from each lobe, in both lungs. Other gross findings were observed and recorded. Tissue sections were made and stained with hematoxylin and eosin and evaluated under a microscope. Results Out of 103 cases studied, 88.3% were male with mean age of 35.8 + 16.6 years. In females, the mean age was 31.6 + 10.4 years. The mean weight of lungs was found to be 627.3 + 138.5g and 591.7 + 129.7g for the right and left lung, respectively, in males. In females, the mean weight of lungs was 616.7 + 166.1g and 583.3 + 155.8g for the right and left lung, respectively. More than half (53.4%) of lung samples had some pathological disease, and the leading diagnosis was pulmonary congestion/oedema (22.3%) followed by lobar pneumonia (18.5%). Age was found to relate with the observed histological diagnosis of the lungs. Conclusion Males, especially the youth and adults are the main victims of medico-legal deaths. The study also revealed high prevalence of undiagnosed lung diseases in victims of medico-legal deaths. These findings may reflect heavy burden of lung diseases in the general population.