Histomorphological study of liver in acute poising: is it possible to identify a specific markers?

The aim of the study was to verify, through the identification of eventual specific histological hepatic markers, the existence of a possible cause-effect relationship between the toxic substance and the acute hepatic damage. The possible correlation between toxic substance and hepatic damage would represent in fact for the forensic pathologist a valuable parameter. The Authors selected from Archives of Milan Legale Medicine Institute 263 cases. The cases selected were due to acute poising and occurred in the period between January 1993 and December 2005. 74 cases were due to acute poising because of uncorrected assumption of drugs and 132 of acute poisoning from toxic substances. The Authors selected 63 control cases of subjects died because natural death or other exogenous lesions. The age range comprised nearly all the decades (3-91aa) with greater incidence for the V-VI decade. The hepatic sections have been underwent Hematoxilin-Eosin staining and special staining (Masson’s trichrome, Pearl’s, PAS, Hall's and Gomori stains). The contribution from the pathological evaluations, though may be important to demonstrate the existence of hepatic lesions, failed to demonstrate an etiological relationship between lesions and toxic substance because of three factors: not specificity of hepatic lesions, tropism of toxic substance and chemical nature of toxic substance. Because is impossible to demonstrate specific hepatic histological markers related to acute poising it is necessary all forensic parameters: history, autopsy findings, histological and chemical-toxicological findings result are available to carry out a proper forensic evaluation of this kind of lesions.