Pulmonary Asbestosis: Iv. The Asbestos Body And Similar Objects In The Lung

Our plain-English summary of Pulmonary Asbestosis: Iv. The Asbestos Body And Similar Objects In The Lung, by K.M. Lynch (1937).

The study

• Author: K.M. Lynch
• Published: Journal Of The American Medical Association 109(24):1974-1978, December 11 (1937)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 002924. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article from a Charleston pathology department described asbestos bodies (asbestos fibers with a golden or brownish, iron-containing coat) and similar objects. It drew on the author's autopsy and sputum observations, with four numbered cases but no overall totals or rates. A man who had worked five years in an asbestos factory carding room had asbestos bodies in his lungs but no definite fibrosis, only phagocytosis. The bodies were found in the sputum of an asbestos plant engine room worker with no lung abnormality. They did not appear in sputum from three patients with long-standing extreme lung fibrosis and many bodies in the lung at autopsy. Similar brown bodies were found in a coal chute worker, a cotton compress worker and a woman, none of whom had worked in asbestos, and in people who died of heart failure. In some such cases asbestosis was diagnosed until no occupational exposure was found. Similar coated bodies appeared in silicosis. The author suggested that all these objects appear to form on a silica base, making the asbestos body, on that hypothesis, one of a group of "silica bodies."

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: Descriptive pathology report based on the author's autopsy and sputum observations, with four numbered illustrative cases; no statistical analysis
• Who was studied: Autopsy and sputum material seen by the author, whose affiliation was a pathology department in Charleston. Case 1 was a Negro man aged 35 who had worked in the carding room of an asbestos factory. Case 2 was a Negro coal chute worker aged 32 who never worked in asbestos. Case 3 was a Negro woman who never worked in asbestos. Case 4 was a Negro cotton compress worker aged 45 who never worked in asbestos. Others were three patients with extreme lung fibrosis whose sputum was examined, patients who died of heart failure, a worker at an asbestos plant, and a small number of silicosis cases. No overall total is given.
• Exposure: Asbestos dust (fiber type not named), for example five years in the carding room of an asbestos factory without adequate dust disposal. Comparison exposures were coal dust, cotton compress work, and silica dust.
• Main results:
  • In Case 1, despite heavy exposure, the asbestos bodies in the lungs were met with no definite fibrous or other reaction, only phagocytosis.
  • Asbestos bodies were found in the sputum of an engine room worker at an asbestos plant whose exposure was not material and who showed no evidence of lung abnormality.
  • In three cases of long-standing extreme lung fibrosis with many bodies seen in the lung at autopsy, the bodies did not appear in a number of sputum specimens.
  • The author interpreted the sputum findings this way: absence of bodies from sputum may be consistent with advanced asbestosis, and their presence does not necessarily mean actual lung damage.
  • Smaller bodies that took a hematoxylin stain instead of the golden-brown color were taken by the author to be altered asbestos bodies, changed in substance and decreased in size.
  • Brown bodies closely resembling asbestos bodies were found in the lungs of a coal chute worker, a cotton compress worker and a woman, none of whom had worked in asbestos, and in people who died of heart failure. They gave the prussian blue reaction for iron.
  • In some cases a diagnosis of asbestosis was made on routine examination until investigation showed no occupational exposure.
  • In silicosis cases, dust particles had an enveloping substance similar in color and appearance to that of asbestos bodies (silica bodies).
• The authors' conclusion: The author concluded that asbestos bodies may be mimicked by other lung deposits. The author also put forward, as a hypothesis, that all these objects appear to form on a silica base. On that hypothesis, the asbestos body would be one member of a group of silica bodies.
• Limitations the authors state:
  • The author had few silicosis cases, so the observations on silica bodies were not extensive.
  • How long asbestos bodies stay intact within tissues is unknown.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Asbestos Bodies, Pathology, Autopsy, Sputum, Carding, Fibrosis, Phagocytosis.

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