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Post-mortem analysis of bone marrow osteoclasts using tartrate-resistant acid phosphatase staining: does histochemistry work and correlate with time since death?
  1. Joachim Boehm1,
  2. Ulrike Schmidt2,
  3. Michéle Porsche1,
  4. Juergen Veeck3,
  5. Hans-Eckart Schaefer1
  1. 1Institute of Pathology, Freiburg University Medical Center, Freiburg, Germany
  2. 2Institute of Legal Medicine, Freiburg University Medical Center, Freiburg, Germany
  3. 3Institute of Pathology, University Hospital Aachen, Aachen, Germany
  1. Correspondence to Dr Joachim Boehm, Institute of Pathology, Freiburg University Medical Center, Postfach 214, Freiburg D-79002, Germany;{at}


Aims In bone marrow (BM) biopsies, tartrate-resistant acid phosphatase (TRAP) staining represents the gold standard for the characterisation of osteoclasts. TRAP is one of the few enzymes that is histochemically detectable on formalin-fixed paraffin-embedded tissue. This study investigated whether TRAP is also able to visualise BM osteoclasts in autopsy tissue. It was hypothesised that, due to a progressive loss of enzymatic activity in osteoclasts post-mortem, TRAP staining could allow the time of death of a patient to be determined.

Methods TRAP-stained BM slides of 96 cases including 51 pathology and 23 forensic autopsies and 22 biopsies were histologically evaluated and their staining intensity (SI) semi-quantitatively graded. In the autopsy cases, the results were correlated with the post-mortem interval (PMI, time span in days between death and autopsy).

Results TRAP staining intensities (TRAP-SIs) did not differ between men and women and showed a steady decrease with age. TRAP-SIs were significantly stronger in biopsies than in autopsy cases. Among the autopsies, TRAP-SIs were highly variable and not dependent on PMI, except for three forensic cases with PMI ≥7 days which showed a complete loss of TRAP stainability. On the whole, the TRAP-SIs of pathology and forensic cases did not differ significantly.

Conclusions This study clearly shows that BM osteoclasts stay TRAP-positive for 7 days post-mortem, although with markedly reduced TRAP-SIs compared with biopsies. Since TRAP-SIs were not correlated with the duration of PMI, TRAP staining of BM osteoclasts cannot serve as a tool to determine the time of death of a patient.

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