Pleural Calcification And Mesothelioma Following Exposure To Asbestos

Our plain-English summary of Pleural Calcification And Mesothelioma Following Exposure To Asbestos, by S.J. Steel, J. Boyd (1965).

The study

• Authors: S.J. Steel, J. Boyd
• Published: British Journal Of Diseases Of The Chest 59(3):130-132, July (1965)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 001544. The article is still under copyright, so we describe it here rather than post it.

In plain English

This was a case report with a brief literature review. The authors described a 63-year-old man admitted in March 1964 with cough, breathlessness and weight loss. He had spent twenty years in charge of the stores of a firm distributing asbestos insulating materials, then moved to office work ten years earlier. The article did not name the fiber type in this patient's exposure. He smoked 40 cigarettes a day. Chest X-rays from 1951, 1954 and 1959 had shown calcified pleural plaques on both sides. In 1964 the X-ray showed left-sided pleural thickening and fluid. His illness was first treated as probably tuberculous. A compressed-air drill biopsy showed mesothelioma of the pleura, with an asbestos body in the adjacent lung. He died a month later, and no post-mortem was done. The authors noted that his exposure was slight and remote in time. They wrote that whether pleural calcification has prognostic significance for mesothelioma would probably have to wait for long-term follow-up of a large series. They concluded that patients with pleural calcification should be asked carefully about asbestos exposure and kept under observation.

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 one patient, with a brief review of earlier published reports
• Who was studied: one 63-year-old man admitted in March 1964 (The London Chest Hospital and The Romford Chest Clinic, London) with persistent cough, sputum, increasing breathlessness on exertion and weight loss
• Exposure: twenty years in charge of the stores of a firm distributing a variety of asbestos insulating materials for industry and the building trade. He had no further asbestos contact after moving to office work ten years earlier. The article does not name the fiber type in this patient's exposure. Anthophyllite and crocidolite are mentioned only in describing earlier studies.
• Main results:
  • The patient smoked 40 cigarettes a day, and his father had died of bronchial carcinoma.
  • Earlier chest X-rays (1951, 1954, 1959) of the patient had shown calcified pleural plaques on both sides.
  • Because of a strongly positive Mantoux test and a raised sedimentation rate, the illness was first judged probably tuberculous and treated with anti-tuberculous drugs.
  • A biopsy taken with a high-speed compressed-air drill showed mesothelioma of the pleura, 10 years after the patient's exposure as a store-keeper.
  • An asbestos body was present in the lung next to the tumour in the biopsy.
  • After the biopsy, asbestos bodies were found in the sputum for the first time. Earlier sputum had been negative for them.
  • The patient died a month after the biopsy.
  • The authors commented that the exposure in this case was slight in degree and remote in time.
• The authors' conclusion: The authors concluded that whether pleural calcification has prognostic significance for later pleural mesothelioma would probably have to wait for long-term follow-up of a large series. They considered that the sequence of events in this case indicated it is advisable to enquire carefully into asbestos exposure in all patients with pleural calcification and to keep them under observation.
• Limitations the authors state:
  • No post-mortem examination was performed.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Calcification, Mesothelioma, Chest X-Ray, Pleural Plaques, Pleural Thickening, Biopsy, Pleura, Asbestos Bodies.

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