Pulmonary asbestosis and carcinoma: report of a case with necropsy findings

Our plain-English summary of Pulmonary asbestosis and carcinoma: report of a case with necropsy findings, by Dan S. Egbert, Arthur J. Geiger (1935).

The study

• Authors: Dan S. Egbert, Arthur J. Geiger
• Published: American Review of Tuberculosis, pp. 143 ff. (Yale University School of Medicine, New Haven) (1935)
• 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

This article was a case report of one man with pulmonary asbestosis and primary carcinoma of the lung, with findings from necropsy (autopsy). The patient was a Hungarian factory hand who had worked for 18 years as a weaver in an asbestos factory. The article does not name the type of asbestos. He was admitted to the Tuberculosis Ward of the New Haven Hospital on May 11, 1934. X-rays were read as pneumonoconiosis with a probable malignant tumor of the left lower lobe, and showed bone lesions characteristic of metastatic carcinoma. No tubercle bacilli were found in 6 sputum specimens. He died after ten days in hospital. At necropsy, both pleural cavities were obliterated by fibrous adhesions. Microscopy confirmed a primary tumor in a bronchus of the left lower lobe, which had spread to lymph nodes, the right adrenal gland, an abdominal muscle, the pelvis, vertebrae and skull. Asbestosis bodies were found throughout the lung, including within the cancer. The authors called this apparently the first such report. They concluded that inhaled asbestos having been a significant factor in this man's cancer seemed plausible enough to be worth considering.

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 with necropsy findings
• Who was studied: One man (J. V.), a Hungarian factory hand, admitted to the Tuberculosis Ward of the New Haven Hospital, New Haven, Connecticut, on May 11, 1934
• Exposure: Worked as a weaver in an asbestos factory for 18 years without interruption. Dust levels were greatly reduced by changes at the factory two years before his hospitalization. The fiber type is not stated.
• Main results:
  • X-ray findings in this patient were summarized as pneumonoconiosis with infiltration of the left lower lobe, probably due to a malignant bronchogenic tumor. Destructive bone lesions in the pelvis and lumbar spine were characteristic of metastatic carcinoma.
  • No tubercle bacilli were found in any of 6 sputum specimens from the patient.
  • The patient had fever throughout ten days in hospital and died within minutes of a sudden collapse after violent coughing spells.
  • At necropsy, both pleural cavities were completely obliterated by firm fibrous adhesions, and the pleura was thickened, dense and hyalinized.
  • Histological sections confirmed that the primary tumor (carcinoma) arose in the bronchus of the lower lobe of the left lung.
  • Large numbers of asbestosis bodies were found in fluid scraped from the cut lung surfaces. They were scattered throughout the lung tissue, mostly in the alveoli, and also extended through the cancerous areas.
  • Tumor metastases were found in the lungs and tracheobronchial lymph nodes, the aortic lymph nodes, the right adrenal gland, the left external oblique abdominal muscle, the bony pelvis, the vertebrae and the skull.
• The authors' conclusion: The authors described the report as apparently the first to describe primary lung carcinoma as a condition associated with pulmonary asbestosis. They concluded that the irritating effects of inhaled asbestos particles having been a significant factor in this patient's primary lung cancer seemed plausible enough to be worth considering.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Carcinoma, Autopsy, Sputum, Bronchus.

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