Bronchiogenic carcinoma in association with pulmonary asbestosis: report of two cases

Our plain-English summary of Bronchiogenic carcinoma in association with pulmonary asbestosis: report of two cases, by H. B. Holleb, A. Angrist (1941).

The study

• Authors: H. B. Holleb, A. Angrist
• Published: Queens General Hospital, Jamaica, N.Y. (Department of Pathology); received for publication May 19, 1941; pp. 123-
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

Two pathologists at Queens General Hospital, New York, reported two cases in this article, received for publication in May 1941. Both were white men who had covered steam and water pipes with asbestos for 25 years. No fiber type was named. The first man, aged 52, died in hospital; autopsy showed squamous-celled lung carcinoma of the right upper lobe, spread to lymph nodes, kidney and adrenal, with pulmonary asbestosis. The second man, aged 55, had not been exposed to asbestos dust for the 10 years before death; his history came from his son, whose knowledge of some details was admittedly inaccurate. He had a widely spread large oat-celled carcinoma of the right lower lobe, also with pulmonary asbestosis. Lung silica was not clearly raised in either man, and the authors offered an explanation. These were the only two pulmonary asbestosis cases seen in the department; the authors found it striking that both had lung carcinoma, though of no statistical significance. They tabulated all ten recorded cases as a summary, not necessarily supporting an earlier claim that lung cancer is occupational in asbestos workers.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of two autopsied cases, with a table summarizing all previously recorded cases of pulmonary asbestosis with lung carcinoma
• Who was studied: Two white men, aged 52 and 55, examined at autopsy at Queens General Hospital, Jamaica, New York. For comparison, the authors also gave cancer figures from 2,451 routine autopsies at that hospital.
• Exposure: Both men worked about 25 years as pipe-coverers, covering steam and water pipes with asbestos fabric. The second man also used large amounts of powdered asbestos cement, usually in unventilated cellars. He was employed as a salesman and not exposed to asbestos dust for the 10 years before death. No fiber type is named.
• Main results:
  • Case 1: bronchiogenic non-keratinizing squamous-celled carcinoma of the right upper lobe, with metastases to mediastinal lymph nodes, the right kidney and a right adrenal cortical adenoma, plus pulmonary asbestosis
  • Case 1: lung sections showed diffuse interstitial fibrosis and a moderate number of asbestosis bodies
  • Case 2: bronchiogenic large oat-celled carcinoma of the right lower lobe, with metastases to lymph nodes, liver, kidneys, cerebral cortex, ribs and vertebrae, plus pulmonary asbestosis
  • Case 2: lung sections showed widespread interstitial fibrosis but only occasional asbestosis bodies
  • Case 1 lungs contained 240 mg of silicon dioxide per 100 gm of dried lung. The authors judged this only slightly elevated against a 200 mg per cent standard.
  • Case 2 lungs contained 4.5 mg of silicon dioxide per 100 gm of dried lung. The authors placed this within known non-pathological limits.
  • In the hospital's routine autopsies, bronchiogenic carcinoma made up 14.71 per cent of all carcinomas and 2.41 per cent of routine autopsies
  • The only two cases of pulmonary asbestosis seen in the department both had bronchiogenic carcinoma
• The authors' conclusion: The authors presented the two cases and offered an explanation for why lung silica was not elevated despite asbestosis: inhaled fibers can dissolve and disappear, and both men had long but relatively low exposure. They presented their table of all reported cases merely as a summary. They said it was not necessarily support for Nordmann's conclusion that lung cancer is an occupational disease of asbestos workers.
• Limitations the authors state:
  • The history for case 2 was obtained from the patient's son after the autopsy, and the son's knowledge of some details was admittedly inaccurate
  • The authors found no strict criteria in the literature for diagnosing pulmonary asbestosis, and the silica test did not confirm the diagnosis
  • The authors said the finding of carcinoma in the only two asbestosis cases was of no statistical significance

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Asbestosis, Autopsy, Statistical Significance, Lung Cancer.

Browse return to medical research.