Forensic histopathology, essential for determining cause of death and disease diagnosis, is severely impeded by postmortem autolysis, i.e., an irreversible, stochastic degradation process that distorts tissue morphology and introduces diagnostic subjectivity, thereby underscoring the value of restoring autolyzed images to a diagnostically plausible, pre-autolysis state for improving objectivity in forensic practice. This restoration task is fundamentally challenging due to the large, non-deterministic morphological changes caused by autolysis and the infeasibility of pixel-wise paired data, which invalidates assumptions underlying supervised and cycle/structure-consistent unpaired translation methods. To address this, we formalize forensic histopathology autolysis restoration as a new task: under unpaired supervision, transform postmortem images with severe autolysis into diagnostically meaningful ``antemortem'' representations. We contribute AutoPath, the first homologous yet unpaired dataset for this problem, constructed by splitting specimens into adjacent tissue blocks---one processed immediately, the other exposed to induce autolysis---yielding nearly ten thousand $10\times$ patches from 69 cases with varying liver conditions. We further frame the problem as a Schrödinger Bridge between the autolyzed and non-autolyzed distributions, offering a principled approach to modeling stochastic, severe morphological degradation. Critically, we demonstrate the misalignment of generic image-level generative metrics (e.g., FID) with diagnostic utility and propose a forensically grounded, slide-level diagnostic distribution consistency evaluation. Overall, this work establishes a reproducible benchmark (encompassing task definition, a real-world dataset, and an evaluation methodology) toward rigorous and practically meaningful progress in autolysis restoration for forensic pathology.
Unpaired image-to-image translation must decide, per image, what to change and what to preserve without paired supervision. Many diffusion-based unpaired translators control preservation through a single global noise or guidance value applied across the image, which cannot separate content to keep from appearance to change. We present PRISM, a GAN-free flow-matching framework that replaces this global control with a learned per-feature gate. The gate's spatial prior is derived from each source feature's standardized distance to the target feature distribution, so features far from the target are freed while target-consistent features are preserved. The same gate controls both the initialization, which mixes the real source latent with a task-matched corruption, and the transport timing during Ordinary Differential Equation (ODE) integration. The corruption is matched to the task, content-anchored (AdaIN) for structure-preserving translation and partially anchored for structure-changing translation, and the gate can be overridden locally at inference from text or a detector without retraining, preserving important structures of the original image while still generating realistic results. We evaluate PRISM on five natural and biomedical benchmarks (AFHQ cat->dog, CelebA-HQ appearance translation, day->night relighting, virtual staining, and breast frozen->permanent histopathology). Among the evaluated methods under a shared same-split protocol, PRISM attains the best Inception FID and KID on four benchmarks and a competitive result on the fifth, and on histopathology yields the nuclei-count ratio closest to the ideal, supporting a favorable balance between target realism and structural preservation.