Incidental Finding in Histopathology Report of Unnatural Deaths: A Six-year Retrospective Study

Incidental histopathological findings during medicolegal autopsies provide valuable insights into the underlying health status of individuals who appear clinically healthy during life. Such findings contribute to understanding silent disease burdens in the community. A six-year retrospective study (2016–2021) was conducted at a tertiary care institute in Northeast India, analyzing medicolegal autopsy cases of apparently healthy individuals with no documented chronic illness who died due to unnatural causes. A total of 199 cases with significant incidental histopathological findings were included. Atherosclerosis was the most prevalent incidental finding (41%), followed by pulmonary edema (12%), diffuse alveolar damage (7%), interstitial pneumonitis (6%), and viral hepatitis (5%). The highest frequency of incidental lesions was observed in the 40–60-year age group. Notably, early atherosclerotic changes were identified even in individuals as young as 22 years. Although incidental findings did not contribute to the cause of death, they revealed a substantial burden of asymptomatic pathology in the population. These observations highlight the relevance of autopsy-based surveillance in understanding the epidemiology of silent diseases and their potential public health implications.