Two Cases of Squamous Carcinoma of the Lung Occurring in Asbestosis

Our plain-English summary of Two Cases of Squamous Carcinoma of the Lung Occurring in Asbestosis, by S. Roodhouse Gloyne (1935).

The study

• Author: S. Roodhouse Gloyne
• Published: Tubercle, October 1935, pp. 5-10 (article begins on p. 5)
• 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 1935 article from the journal Tubercle described two women who had worked with asbestos. Both were examined after death. One had been exposed to asbestos dust for eight years as a spinner and survived nine years afterwards. The other had two short periods of exposure, six months and thirteen months, in the mattress and opening departments of the factory, and lived fifteen years afterwards. Both had pulmonary asbestosis and a small squamous carcinoma of the lung that had not been recognised during life. Neither showed signs of tumour elsewhere in the body. Under the microscope, the cancer appeared to start in the wall of a small bronchus. Its spread was to a marked extent limited by the scarring of asbestosis, though on balance the growth got the upper hand and slowly progressed; it pushed aside pigment, asbestos fibres and asbestosis bodies. The author stated that the cases were recorded to point out features of the tissue, not to argue that asbestosis causes lung cancer. The author tentatively suggested that in asbestosis a small tumour may "turn the scale" towards death.

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 autopsy cases with microscopic (histological) examination
• Who was studied: two women asbestos workers examined at autopsy; one survived nine years and the other fifteen years after exposure ended, with work histories going back to the war years
• Exposure: asbestos dust: Case 1 had eight years' exposure as a spinner; Case 2 had two short periods of six months and thirteen months in the mattress and opening departments of the factory
• Main results:
  • Case 1 had typical pulmonary asbestosis of moderate severity, with a growth about the size of a small walnut in the base of the right upper lobe
  • Case 2 had several small, soft, necrotic nodules of growth in the right lower lobe
  • In both cases the lung tumours were very small and had not been recognised during life
  • Neither case had secondary deposits (spread of the tumour elsewhere)
  • The tumours were classed as squamous because of prickle cells, keratinisation and cell nests
  • The carcinoma appeared to arise in the wall of a small bronchus
  • The growth's spread was to a marked extent limited by the asbestosis fibrosis
  • In places the fibrosis appeared to compress and degenerate the growth, but on the balance the growth got the upper hand and slowly progressed
  • Pigment, asbestos fibres and asbestosis bodies were pushed aside by the advancing growth
  • In Case 1, a small meningeal haemorrhage ended life
• The authors' conclusion: The author tentatively suggested that in asbestosis a small tumour may turn the scale towards death, as bronchitis with early bronchopneumonia can.
• Limitations the authors state:
  • The author stated that the cases were not recorded to make a case for a causal (aetiological) link between asbestosis and lung cancer, which the author called still an open question

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Asbestosis, Bronchus, Lung Cancer.

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