Sixty-six individuals >18 years of age andHER2 signaling diagnosed with DAD have been incorporated. Demographic facts and reason behind death were recorded in the autopsy reviews. Hematoxylin- and eosin- (H&E-) stained lung samples obtained from each case were evaluated again by a pathologist Epigenetics Library (HNU) under a light microscope. During this evaluation, cases had been examined in line with the 2002 American Thoracic Society/European Respiratory Society (ATS/ERS) idiopathic interstitial pneumonia consensus criteria (Table 1) . Among the lesions defined in the criteria, alveolar acute inflammation, neutrophilic abscess, and histiocytes were graded for the intensity of alveolar epithelial cell desquamation, eosinophilia, and alveolar chronic inflammation, whereas other lesions as HM (Figure 1) had been graded for diffusion.
Intensity and diffusion parameters have been ranked as (0) none, (1) mild, (2) medium, or (3) severe intensity/diffusion. The presence of any alveolar organizing fibrosis (Figure 2) was accepted as the main criterion to distinguish exudative from proliferative phases . Causes of death were classified according to DAD phase.Figure 1Prevalent hyaline membrane, H&E ��100. Figure 2Alveolar organizing fibrosis, H&E, ��100.Table 1Distribution of the diffusion intensity of histopathological lesions according to diffuse alveolar damage (DAD) phase.Fisher's exact test was used to evaluate the relationship between DAD and death, and logistic regression was used for the DAD phase assessment of the histopathological lesions. Pvalue < 0.05 was accepted as statistically significant.
Statistical evaluations have been performed using SPSS software (version 11.5; SPSS, Inc., Chicago, IL, USA).3. ResultsWe examined 66 persons who have been autopsied between 2006 and 2008 at the Institute of Forensic PIK-3Medicine, Morgue Specialization Department and were diagnosed with DAD. Of these cases, 55 (83.3%) were men and 11 (16.6%) had been women. The mean age of the cases was 53 years, the median was 54 years, and the range was 19�C92 many years.Histopathological examination revealed that 50 (75.7%) cases had been in the exudative phase, and 16 (24.2%) have been in the proliferative phase. Table 1 summarises the distribution of the diffusion intensity of histopathological lesions according to phase.Only the rate of alveolar exudate/oedema was significantly higher in the exudative phase cases (P = 0.003).
The rates of alveolar histiocytic desquamation (P = 0.037), alveolar fibrosis (P = 0.017), chronic inflammation (P = 0.02), and alveolar fibrin (P = 0.001) were significantly higher in the proliferative cases than in the exudative cases. No significant difference between the distribution of exudative and proliferative phases was observed for other examined lesions. In contrast, in the logistic regression analysis, only the presence of alveolar fibrin as an independent variable was predictive of a diagnosis in favour of proliferative cases (P = 0.016).