Context: Autopsy is a medical practice where post mortem examination of the body is performed to determine the cause of death. Internal organs are studied by gross evaluation and correlated with histopathological findings. Lung pathologies include a wide range of infectious, inflammatory, neoplastic, and occupational diseases. Determining the cause of death helps in future patient management and also helps to adopt prophylactic measures to prevent pulmonary dysfunction.

AIM: This study evaluates the histopathological spectrum of pulmonary lesions in autopsies, which were the direct cause of death or incidental findings.

SETTINGS AND DESIGN: This was a retrospective study conducted on lung autopsies, in the department of pathology, for a period of 4 years.

MATERIALS AND METHODS: After gross examination, formalin fixed paraffi n-embedded lung sections were stained, histopathological evaluation was performed, and findings were recorded and tabulated. Statistical analysis based on frequency was done.

RESULTS: This study includes a total of 240 cases. The most common age group was between 41 to 50 years, followed by 31 to 40 years. Also, a male predominance of 74.58% was noted in the study. On histopathological evaluation, 7.5% of cases were autolyzed, and 4.16% had normal histomorphology. The most common finding was mild pulmonary congestion, followed by pulmonary edema. These findings can occur secondary to a terminal event. Hence the most common finding that can cause mortality is acute pneumonia. Other common findings were emphysema, diff use alveolar damage, intra-pulmonary hemorrhage, and pulmonary vein thrombosis.

CONCLUSION: Infectious pathologies are the main pulmonary lesions that lead to death. Early diagnosis and treatment can reduce these preventable causes of mortality.

KEY MESSAGE: Acute pneumonia is the most common pathology that accounts for mortality. Pulmonary tuberculosis also contributes a fair number to mortality. Early diagnosis and treatment can reduce these preventable causes of mortality. Public awareness about these diseases can reduce morbidity and mortality to a greater extent.