Pathological and Radiographic Evaluation of Asbestos Exposure.
Di Wu, Kenzo Hiroshima, Fumikazu Sakai, Takumi Kishimoto, Toshikazu Yusa, Kazuo Onishi, Ikuji Usami, Tetsuyuki Morikawa. Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan; Saitama Medical University, Hidaka, Japan; Okayama Rosai Hospital, Japan; Chiba Rosai Hospital, Ichihara, Japan; Kobe Rosai Hospital, Japan; Asahi Rosai Hospital, Owari Asahi, Japan; Yokohama Rosai Hospital, Japan
Background: Japanese government compensates patients with asbestos-related lung carcinoma, and the evaluation for the compensation of the cases with lung carcinoma depends on the asbestos body counts in lung digests and radiographic features such as pleural plaque and fibrosis. However, there are few data on the relationship between the number of asbestos bodies in tissue sections and the level of asbestos exposure. Furthermore, there is no data on the relationship between radiographic findings of the patient and the level of exposure.
Design: We studied the asbestos body counts by phase-contrast microscopy on lung digests of wet formalin-fixed lung in 175 cases with asbestos-related diseases (161 lung carcinomas, 5 mesotheliomas, 4 asbestosis, 3 interstitial pneumonia, 1 fibrosis, 1 unknown). We counted the asbestos bodies in 4 micron paraffin-embedded sections of lung tissues stained with iron in 113 cases with asbestos-related lung carcinoma, and compared them with the asbestos body counts in lung digests. We analyzed radiographic findings of 97 asbestos-related lung carcinomas.
Results: The distribution of the log of asbestos concentration was normal. There is statistically significant relationship between numbers of asbestos bodies in tissue sections and asbestos body counts measured by tissue digestion technique (correlation coefficient = 0.918). The number of asbestos bodies in the lung was significantly higher in the patients with pleural plaque detected by computed tomography (geometric mean (GM), 7,349/g dry lung) and those with pleural plaque and fibrosis (GM, 17,148/g dry lung). However, the number of asbestos bodies in the lung was significantly lower in the patients with pleural plaque detected during the thoracoscopy or surgery (GM, 202/g dry lung). The number of asbestos bodies in the lung of the patients with pleural plaque which occupies more than one fourth of thoracic circumference was higher than that of the patients with pleural plaque which occupies less than one fourth of thoracic circumference.
Conclusions: The number of asbestos bodies in the tissue section of the lung was related to the number of asbestos bodies in the lung in lung digests. The radiographic findings such as pleural plaque and fibrosis suggest the history of asbestos exposure, and the extent of pleural plaque helps to estimate the level of asbestos exposure.
Wednesday, March 2, 2011 9:30 AM
Poster Session V # 263, Wednesday Morning