Pulmonary Asbestosis Report of a Case with Necropsy Findings

Our plain-English summary of Pulmonary Asbestosis Report of a Case with Necropsy Findings, by D.S. Egbert (1933).

The study

• Author: D.S. Egbert
• Published: American Review of Tuberculosis (1933)
• 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 reported necropsy (autopsy) findings in one man with pulmonary asbestosis. It also summarized 28 fatal cases of pulmonary asbestosis from the medical literature, including this one. The man, 30 years old, was admitted to hospital in May 1929 with difficulty breathing, after years of asbestos factory work. His breathlessness worsened, and he died suddenly in September 1932, sixteen years after starting asbestos work. The necropsy was limited to the chest. It found fibrous adhesions obliterating the pleural cavities, leathery lungs, and many asbestosis bodies. Among the 18 reviewed cases where death seemed mainly due to lung fibrosis from asbestos dust, all were asbestos factory workers. Exposure before symptoms averaged 9 years and total exposure averaged 16 years, when reported. Across all the reviewed cases, 6 had active pulmonary tuberculosis, which was the main cause of death in 3. The article gives that total as 28 in its summary but 25 in its comment section. The author stated that asbestosis is distinguished from other dust diseases by asbestosis bodies and by diffuse fibrosis tending to be more marked around the bronchioles.

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 (autopsy) findings, plus a summary of 28 fatal cases of pulmonary asbestosis from the literature (including the present case)
• Who was studied: One 30-year-old white male admitted to William Wirt Winchester Hospital on May 26, 1929; he died September 24, 1932. Also 28 published fatal cases of pulmonary asbestosis, including this one.
• Exposure: Work in an asbestos factory, beginning sixteen years before death; he stopped work three and one-half years before death. No fiber type is named.
• Main results:
  • At necropsy, the pleural cavities were completely obliterated by firm, fibrous adhesions.
  • Both lungs were leathery.
  • A smear of fresh lung showed large numbers of asbestosis bodies; these were also found in the thickened pleura and lung tissue.
  • In the upper lobe of the right lung, tissue was mostly dense fibrous connective tissue in which asbestosis bodies were scarce.
  • The tracheobronchial lymph nodes contained many collections of black pigment granules and very few asbestosis bodies.
  • The right ventricle of the heart was dilated.
  • In the literature review, 18 cases were identified in which death seemed primarily the result of pulmonary fibrosis from inhaled asbestos dust; all were workers in asbestos factories.
  • Of those 18 cases, 9 of the 14 with age reported were between 31 and 36 years old.
  • In those 18 cases, when reported, exposure to dust before symptoms began averaged 9 years, and total exposure averaged 16 years.
  • Across all the reviewed cases (not only the 18-case subgroup), active pulmonary tuberculosis was present in 6, and death was primarily due to tuberculosis in 3. The summary gives the total as 28 cases; the comment section gives it as 25.
• The authors' conclusion: The author stated that telling asbestosis apart from other forms of pneumoconiosis under the microscope rests on characteristic asbestosis bodies. It also rests on the type and distribution of the fibrosis: diffuse, with a tendency to be more marked around the bronchioles, unlike the nodules of silicosis.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Autopsy, Fibrosis.

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