{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:02:32Z","timestamp":1760234552482,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Coronavirus disease 2019 (COVID-19) has shown the importance of postmortem investigation of deceased patients. For a correct interpretation of the pulmonary findings in this new era, it is, however, crucial to be familiar with pathologic pulmonary conditions observed in postmortem investigations in general. Adequate postmortem histopathological evaluation of the lungs may be affected by suboptimal gross work up, autolysis or poor fixation. Using a standardized preparation approach which consisted in instillation of 4% buffered formaldehyde through the large bronchi for proper fixation and preparing large frontal tissue sections of 1\u20132 cm thickness after at least 24 h fixation, we comprehensively analyzed postmortem pulmonary findings from consecutive adult autopsies of a two-year period before the occurrence of COVID-19 (2016\u20132017). In total, significant pathological findings were observed in 97\/189 patients (51%), with 28 patients showing more than one pathologic condition. Acute pneumonia was diagnosed 33\/128 times (26%), embolism 24 times (19%), primary pulmonary neoplasms 18 times (14%), organizing pneumonia and other fibrosing conditions 14 times (11%), pulmonary metastases 13 times (10%), diffuse alveolar damage 12 times (9%), severe emphysema 9 times (7%) and other pathologies, e.g., amyloidosis 5\/128 times (4%). Pulmonary\/cardiopulmonary disease was the cause of death in 60 patients (32%). Clinical and pathological diagnoses regarding lung findings correlated completely in 75 patients (40%). Autopsy led to confirmation of a clinically suspected pulmonary diagnosis in 57 patients (39%) and clarification of an unclear clinical lung finding in 16 patients (8%). Major discrepant findings regarding the lungs (N = 31; 16%) comprised cases with clinical suspicions that could not be confirmed or new findings not diagnosed intra vitam. A significant proportion of acute pneumonias (N = 8; 24% of all cases with this diagnosis; p = 0.011) was not diagnosed clinically. We confirmed the frequent occurrence of pulmonary pathologies in autopsies, including inflammatory and neoplastic lesions as the most frequent pathological findings. Acute pneumonia was an important cause for discrepancy between clinical and postmortem diagnostics<\/jats:p>","DOI":"10.3390\/diagnostics11050894","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T06:01:33Z","timestamp":1621317693000},"page":"894","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Frequency and Significance of Pathologic Pulmonary Findings in Postmortem Examinations\u2014A Single Center Experience before COVID-19"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-9791","authenticated-orcid":false,"given":"Sabina","family":"Berezowska","sequence":"first","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"},{"name":"Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Schmid","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tereza","family":"Losmanov\u00e1","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mafalda","family":"Trippel","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Blank","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yara","family":"Banz","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Jakob","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Inselspital, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9491-3609","authenticated-orcid":false,"given":"Rupert","family":"Langer","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Bern, Murtenstrasse 31, 3008 Bern, Switzerland"},{"name":"Institute of Pathology and Molecular Pathology, Kepler University Hospital, Johannes Kepler University Linz, Krankenhausstr 9, 4021 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/his.14134","article-title":"Post-mortem examination of COVID19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction","volume":"77","author":"Menter","year":"2020","journal-title":"Histopathology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s00428-020-02887-5","article-title":"Unlocking the lockdown of science and demystifying COVID-19: How autopsies contribute to our understanding of a deadly pandemic","volume":"477","author":"Tzankov","year":"2020","journal-title":"Virchows Arch."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41379-020-00661-1","article-title":"COVID-19 pulmonary pathology: A multi-institutional autopsy cohort from Italy and New York City","volume":"33","author":"Borczuk","year":"2020","journal-title":"Mod. 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