The document provides guidance on the proper dissection and examination techniques for various organs during an autopsy. It describes how to remove and examine the male and female reproductive systems, kidneys, bladder, prostate, testes, and other organs. Details are given on identifying congenital anomalies, diseases, infections and tumors that may be seen. Common findings for conditions like tuberculosis, infections, cancers, cysts and other pathologies are outlined. The document emphasizes thorough examination and documentation of pathological findings in organs.

1. MODERATOR: DR RAJESH
PRESENTER: DR VIVEK TG

4.  Penis and male urethra are not dissected routinely
unless indicated in condition like
◦ Cong Urethral Valve
◦ Stricture
◦ Tumors
 The penis with or without surrounding skin should be
left attached to urinary bladder. Which is either done by
sawing out a portion of pubic bone or pulling out
through the pubic arch

5. • In the region of inguinal canal the inner surface of
abdominal wall is incised & spermatic cord located.
• This incision should permit the introduction of 2 fingers
of the left hand into the scrotal sac.
• Right hand is used to locate the testis & epidiymis into
the view.
• When these structure appear in the inguinal region they
are cut off from the scrotum with a knife(damage to the
scrotal skin should be looked for)

6.  Removal of male reproductive system :

7. • Removal of female reproductive system :
Pull the uterus, cervix & vagina upwards
Divide the vagina as low as possible
The FTs, uterus & ovaries are freed from the pelvis &
are removed

8.  Removal of bladder along with prostate & seminal vesicles &
terminal segment of rectum :

10.  Kidneys Should be dissected from its fatty capsule. Weight
should be taken with ureters attached
 Weight- Adults- 160 gms
At birth- 26gms
 Size 11x6x3cm
 Ureters : length 25cm
KIDNEY

11.  Kidneys should be held in the left hand, Should be cut
from the convex surface to hilum with a single stroke of
long knife.
 Fibrous capsule has to be stripped with a toothed forceps.
 Any amount of pus noted – between capsule & kidney /
capsule of kidney & surrounding tissue
 The ureter from the pelvis to the bladder should be opened
with a scissors

12.  Thickness of the renal cortex & circumference of the
renal arteries should be measured.
 Papillae should be examined for the areas of necrosis,
crystals or minute stones.
 The block should be taken from renal cortex, medulla with
a papilla & portion of the renal pelvis

13. • Inferior venacava opened (rt renal artery shouldn’t be
cut) :- tumor embolus / thrombus
• Renal vein – checked for thrombus
• Lower abdominal aorta – opened dorsally
• Renal arteries – opened & inspected for patency
/plaques / thrombi
• Atypical vessels – noted crossing pelvis / ureters
(responsible for hydronephrosis)

14.  Urinary bladder
 By placing a scissors blade into the urethra the bladder is
opened from the anterior wall & block is taken for fixation
 Capacity 120-320ml
Urethra:
 Male 18-20cm
Female 4cm

15. Prostate :
 It is cone shaped with
 Base measuring 4cm
 Length 3cm
 Thickness 2cm
 Weight 8gm
 Prostate is incised transversely at several levels
sectioned to include the posterior portion
 Seminal Vesicles
 Size 5cm
 Cut each vesicle longitudinally or transversely. Fluid
content to include of the wall is to be noted. Block is
to be taken

16.  Testis & Epididymis
 Size 4-5x3.5-2x2.7cm
 Weight 10-12 gms
 Vas deference 18 Inches
 With a sliding motion of the long knife the testis should be
cut through,
 The surface should be observed to see the tubules “string”
out normally
 One block each has to be taken from testis & epididymis

17. • Uterus , cervix & Vagina
Uterus
– Size 7.5x5x2.5cm
– Weight 30.40 gms
• Vagina : Anterior wall- 8cm
Posterior wall 10 cm
• With a scissor blade placed in the cervix the uterus should be opened
anteriorly
• Tubes & Ovaries
Tube measure 10cm
• The pointed end of the blade of the scissor should be put in the
fimbriated end and opened longtudianally.
• A block should be taken
• Ovaries : Should be sectioned length wise and a block should be taken

20.  Size- Hypoplasia / hypertrophy / atrophy /enlargement
 Shape
 External surface – scars , abscesses , tubercles ,
petechiae ,cysts , granularity
 Cut surface - corticomedullar differentiation (1:3
ratio) / cysts / abscess/ mass
 Pelvis - calculi , tumor , dilatation ,hydronephrosis
 Papillae - necrosis
 Consistency - soft – ATN / Rubbery - amyloidosis
 Capsule – thickening/ scarring
 Vessels

21.  Scars
 V- shaped scars- infarcts and hypertensive renal
disease
 U- shaped scars- Reflux nephropathy

22. • Capsule – stripped off with difficulty in
- Chronic pyelonephritis
- Benign nephrosclerosis
- Chronic glomerulonephritis
- Surface of the infarcts
Capsule should not be stripped – if
paediatric lesions suspected
eg : nephrogenic rests – located sub capsularly

23. • Ureters – length (25 cms) , palpated for stones , strictures
,inflammation , dilatation & tumors
• Urinary bladder :
Observe – absent anterior wall / residual urine / thickness
of muscle / polyps or diverticuli / trabeculations /
growth / stones / inflammation/ discoloration of mucosa /
rupture (trauma)

24. • Urethra : partial obliteration /inflammation / strictures /
caruncle / tumour growths
Prostate : inflammation / abscesses / TB foci / infarction /
median lobe enlargement / firm gland with yellowish cut
surface (carcinoma)

26. CONGENITAL ANOMALIES :
1 .Agenesis : absence of one kidney
2. Hypoplasia : 5 or less calyces
3. Distopia : congenital misplaced kidney (pelvis)
4. Congenital HORSE SHOE KIDNEY – both the kidneys united at the
lower pole
5 . Supernumerary kidneys
6 . Persistent fetal lobulation

29. 7 . Atresia / stenosis of ureter / double ureters
8. Congenital megalo ureter – enters perpendicularly in to
bladder
9 .NEPHROPTOSIS –kidney easily movable due to absence of
fat tissue & may be displaced to iliac fossa
10.Congenital cysts of the kidney – uni /bilateral , in cortex /
medulla / both , communication with pelvis , contents of cysts
, external surface

30. 1 . Bilateral large cysts & bosselated surface, not communicating
with pelvis:
ADULT POLYCYSTIC KIDNEY DISEASE , each weighing
2-4 kg, not communicating with pelvis (Potter’s type III)
2 . Bilateral large kidneys with smooth external surface :
C/S : cylindrical cysts, radiating appearance
AUTOSOMAL RECESSIVE CHILDHOOD POLYCYSTIC
KIDNEY (Potter’s type I)

31. 3 . Cysts in the medulla : MEDULLARY SPONGE
KIDNEY
4 . Occassional cysts in cortex : Simple renal cysts
5. Normal sized / small contracted kidneys with cysts m/s
1-15mm in the corticomedullary junction :
nephronophthisis –medullary cystic disease complex

32. 6. Reniform mass of cysts of varying sizes obscures
renal parenchyma , uni / bilateral –
normal /enlarged / small : renal cystic dysplasia
a ) Multicystic renal dysplasia : unilateral , enlarged kidneys
with cysts of varying sizes , not associated with congenital
anomalies
b) Diffuse type : bilateral , maintains shape , associated with
other abnormalities
7) Cyst with laminated membrane : HYDATID CYST

36. ARPKD

38. Due to : petechial hemorrhages over the external surface
conditions of flea – bitten kidney :
Acute post streptococcal glomerulonephritis
Malignant nephrosclerosis
Subacute bacterial endocarditis
Hemolytic uremic syndrome
Thrombotic thrombocytopenic purpura
Henoch –schonlein purpura

40. • Anaemia: clay coloured and firm.
• c/s pyramid light than cortex.
• Old case fatty degeneration and soft in consistency.
• Mercury poisoning- cloudy swelling and necrosis of
renal epithelium.
• Carbontetrachloride poisoning- necrotizing
nephrosis, Kidney enlarged and yellowish.
• Diaxane poisoning- hydropic degeneration with
necrosis, Kidney enlarged, pale and yellowish gray.

41. • 1.Chronic glomerulonephritis : b/l symmetrical small ,
contracted kidneys , with a diffusely coarsely
granular surface
• 2.Chronic pyelonephritis : Smallest of the contracted
kidneys , unilateral ,asymmetrical ,
weighing < 100 gms, surface irregularly scarred ,
capsule stripped off with difficulty due to adherence
to U -shaped scars
( Scars seen at both the poles in reflux nephropathy)

42. Granularity- Fine- Benign nephrosclerosis
-Coarse- Chronic glomerulonephritis

44. • 3. Benign nephrosclerosis :
b/l symmetrical small contracted kidneys ,
weighing < 100 gms
Capsule – adherent to surface
Surface – finely granular , with V-SHAPED scars
Other conditions of small , contracted kidney :
diabetes , amyloidosis , myeloma kidney

46. • Tuberculous pyelonephritis :
Often bilateral , involves medulla , papillae
replaced by caseous tissue
With obstruction  calyces filled with caseous
material , pelvis dilated  thin rim of
parenchyma surrounds pelvis ( Putty kidney /
caseous kidney)
• Tuberculosis bladder : reduced capacity due
to extensive sub mucous fibrosis (Thimble
bladder)
• Tuberculosis ureter : dilated , wide mouthed

48. • Renal infarction : it is a pale / anemic infarct ,
wedge shaped– base resting on cortex, apex pointing
towards medulla (occluded artery)
A rim of renal tissue preserved under the capsule
(becoz of capsular vessels)
C/S : red yellow  pale in a week & becomes
depressed below the surface

52. • Centered in the cortex ,well delineated , sometimes as extra
renal mass, satellite nodules may be present
• C/S : solid, at either pole (usually upper) sharply seperated by a
pseudocapsule, hemorrhages, necrosis, cystic change &
calcification-VARIEGATED APPEARNCE
Sometimes a mural nodule formation – extensive necrosis

54. Papillary type
Collecting duct
carcinoma
Medullary renal ca
Chromophobe renal
ca
Sarcomatoid
Other types

58. Solitary
angiomyolipoma -
sporadic

61. Transitional cell
carcinoma of the
renal pelvis.
A mass of
papillary fronds
virtually
fills the pelvic
cavity.

62. Staghorn calculus

64. 1. Red hyperemic mucosa : acute cystitis
2. Solitary polypoidal lesion lobulated / smooth :
inverted papilloma / transitional ca / van brunn’s
nests
3. Confluent papillary tissue with cauliflower
appearance , multiple lesions in surrounding
mucosa : papillary transitional ca
4. Bulky polypoidal tumors with full thickness
involvement & nodular appearance :
sarcomatoid ca/ adeno ca / squamous cell ca/
poorly diff transitional ca

65. 5 . A cluster of edematous smooth surfaced polypoid fronds
protrude in to bladder lumen : Sarcoma botroides /
hamartoma ( particularly in children)
6 . Black nodular mass : Malignant melanoma
7 . Cystic neoplasm dark blue : Hemangioma
8. Black & hemorrhagic mucosa : hemorrhagic cystitis due
to adminstration of chemotherapeutic drugs (
cyclophosphamide)

66. Calculus - bladder

67. Cystitis with malakoplakia Hypertrophy & trabeculation of bladder

68. The tumor is papillary
and focally gelatinous:TCC

69. Melanoma - urethra
The large polypoid
tumor is focally black, suggesting the
diagnosis.

71. Prostate:- median lobe of prostate should be examined
mild enlargement cause urinary obstruction.
Sections are made through lateral and median lobe with
knife.
Acute prostatitis- enlarged, soft in consistency small abcess
may be present.
Chronic:- large, soft, few firm areas.
TB:- enlarged, soft, military nodule, caseous foci, fistulous
tract to rectum.
Carcinoma: 20% of men after 50 shows ca
prostate.Posterior lobe is involved, firm.

72.  Section of prostate showing a irregular shaped
yellowish mass with a small foci of necrosis

75.  Malformations- Cryptorchidism
 Acute orchitis & epididymitis: swollen and firm C/S –
Abscess. Gonorrhea
 Chronic orchitis epididymitis: Smaller & firmer than
normal
 Tuberculosis: - affects epididymis- larger & soft , contains
caseous material, miliary tubercles may be found.
 Syphilis- affects testis – small, white streaks or larger with
elevated well demarcated nodules of rubbery consistency
 Tumours

76.  Spermatic cord: Varicocele, Tumours
 Vas deferens & seminal vesicle: Acute inflammation,
Tuberculosis
 Penis: Cong. Anomalies- Hypo/ Epispadias,
Inflammation- Posthitis, balanitis, Chancroid- round
ulcer with red soft margin, Syphilis-Chancre,
Condylomas, gummas- solitary , rubbery , elastic
 Carcinoma- Cauliflower like mass

78. Large tumor, bulges on c/s

79. Solid nodular areas of necrosis and Hemorrhage

80. Granular part corresponds to EC, Pearly nodules correspond to with
cartilage

81. Replaced testis – granular yellowish area

82. Well circumscribed mass multicystic yellowish keratinous
debris

84. Ovaries, Fallopian tubes, uterus,
Cervix and , Vagina

85.  Abnormalities of ovary: Senile changes, cysts, tumours

86. Multiloculated smooth cyst , cyst lining multiple smoth
locules

87. Multiple papillae locules containg viscid

88. Large uniloculated tumour

89. Well circumscribed solid

90. Well Circumscribed Yellow within which are cystic
foci

91. Fibrous , yellowish

93. Sebaceous material , matted hair

94. Fibrous and whorled – Meig syndrome

97. Peritonitis or gangrene rapidly develop

100. Infiltrating pattern of growth, that invades the myometrium

101. Grape like hydropic villi

102. Diffuse replacement of myometrium extensive hemorrhage

103. Irregular fungating pale neoplastic mass

104. Arising in post vaginal wall

105. • Autopsy diagnosis and technique-Otto Saphir ,4th edi
1961.
• Handbook of autopsy practise, Jurgen Ludwig, 3rd edn
• The essentials of forensic medicine and toxicology – K S
Narayana Reddy.5th ed
• National autopsy workshop GMC Mumbai, 2005.
• Internet sources