Pulmonary giant cells and their significance for the diagnosis of asphyxiation

This study was performed to prove whether the detection of polynuclear giant cells in lungs is useful for the diagnosis of asphyxiation due to throttling or strangulation. Therefore, lung specimens of 54 individuals with different natural and unnatural causes of death were investigated. In most lungs examined numerous alveolar macrophages with 1-2 nuclei were found. Polynuclear giant cells, which were arbitrarily defined as alveolar macrophages containing 3 or more nuclei, were observed in all groups investigated except in the cases of hypoxia due to covering the head with plastic bags. Apparent differences between the other groups in particular an increased number in cases of throttling or strangulation, could not be observed. Immunohistochemical investigations confirmed the hypothesis that the observed polynuclear giant cells were derived from alveolar macrophages. The immunohistochemical analysis of the proliferation marker antigen Ki 67 revealed no positive reaction in the nuclei of polynuclear giant cells indicating that these cells had not developed shortly before death by endomitosis as an adaptative change following reduction in oxygen supply. The results provide evidence that the detection of pulmonary polynuclear giant cells cannot be used as a practical indicator for death by asphyxiation due to throttling or strangulation.