Asbestos bodies in a bile duct cancer after occupational exposure

Our plain-English summary of Asbestos bodies in a bile duct cancer after occupational exposure, by M. Szendröi, L. Németh, G. Vajta (Environmental Research, 1983).

The study

• Authors: M. Szendröi, L. Németh, G. Vajta
• Journal: Environmental Research
• Published: 1983;30(2):270-80
• Type of article: Case report
• Cited by: 35 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000647).

Abstract

A case of asbestosis after 5 years of occupational asbestos exposure is presented. At the postmortem examination, cholelithiasis and a cancer developing from the cystic duct were found and identified histologically as a squamous cell carcinoma. After digesting the tumor tissue, short asbestos bodies and fragments could be identified having a similar shape as those observed in the lung. The possible role of asbestos in the carcinogenesis of the observed bile duct cancer is proposed. The digestive examination of all malignant tumors of any origin after an asbestos exposure is suggested for the identification of the possible presence of ingested asbestos fibers, and to obtain further comprehensive human pathological data.

In plain English

This case report described a woman who was a spinner in an asbestos factory for 5 years from age 24, highly exposed mainly to chrysotile. Twenty-one years later she was diagnosed with serious progressive pleural and lung asbestosis. She had never smoked. Early in five years of follow-up she had a gallstone attack, then pus in the gallbladder. Severe abdominal and lower back pain began a month before her death, and an operation for this pain found an inoperable bile duct cancer spread over the peritoneum. At autopsy the authors found extreme asbestosis with pleural plaques, a gallstone wedged in the cystic duct, and a squamous cell carcinoma growing from the duct wall. Digested tumor tissue contained numerous asbestos body fragments of 3 to 4 micrometres and some longer asbestos bodies of 15 to 20 micrometres, shaped like those in her lung. No uncoated asbestos fibers were found, and chemical analysis of the particles could not be done. The authors suggested asbestos might have promoted the cancer alongside gallstone irritation, but said there might be no causal relation.

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 (single autopsy case with tissue digestion and microscopy)
• Who was studied: One 55-year-old woman, a never-smoker, screened and followed at the National Institute of Occupational and Industrial Health, Budapest, Hungary
• Exposure: 5 years of work as a spinner in an asbestos factory, starting at age 24; high exposure, mainly to chrysotile
• Main results:
  • Twenty-one years after the exposure, serious progressive pleural and pulmonary asbestosis with considerable restriction of breathing function was diagnosed.
  • During a 5-year follow-up, a gallstone attack occurred in the first 6 months, followed by empyema of the gallbladder.
  • A laparotomy (abdominal operation) had to be performed because of severe pain.
  • The severe abdominal-lumbar pains developed one month before her death, and an inoperable bile duct cancer spread over the peritoneum was found.
  • At autopsy there was extreme asbestosis with pleural plaques, a gallstone wedged in the cystic duct, and a tumor arising from the duct wall that infiltrated the liver and gallbladder wall.
  • The bile duct cancer was a squamous cell carcinoma on microscopic examination.
  • In the lung, a great number of asbestos bodies of 10 to 90 micrometres were found.
  • In digested tumor tissue, numerous asbestos body fragments of 3 to 4 micrometres and some longer asbestos bodies of 15 to 20 micrometres were found, with the same shape as those in the lung.
  • Uncoated asbestos fibers were not found in the tumor.
  • Considerably less asbestos appeared to be accumulated in the abdominal tumor and its surroundings than in the lung.
• The authors' conclusion: The authors concluded that gallstone irritation and inflammation are accepted causes of bile duct cancer, but that asbestos may have had a simultaneous, promoting carcinogenic effect. They also stated it is possible there is no causal relation between the asbestos bodies and the tumor.
• Limitations the authors state:
  • The asbestos body-like structure seen in a tissue section near the tumor was not persuasive on its own and could have been a mineral impurity.
  • Energy-dispersive X-ray analysis, which identifies particle composition, could not be done for technical reasons.
  • Microscopy of serial tumor sections did not give positive results because there were relatively few asbestos fibers.
  • The authors stated there may be no causal relation between the asbestos bodies and the tumor.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Asbestos Bodies, Occupational Exposure, Asbestos Exposure, Squamous Cell Carcinoma, Carcinogenesis.

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