Asbestosis: Report Of Two Cases

Our plain-English summary of Asbestosis: Report Of Two Cases, by H.L. Stewart, C.J. Bucher, E.H. Coleman (1931).

The study

• Authors: H.L. Stewart, C.J. Bucher, E.H. Coleman
• Published: Archives Of Pathology 12:909-916, December (1931)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 003235. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1931 article reported two cases of pulmonary asbestosis seen at Jefferson hospitals in Philadelphia. It did not name the type of asbestos. The first patient had worked nine years as a spinner in an asbestos mill and had worn dust protectors in the nostrils. That patient died of peritonitis after gallbladder surgery. At autopsy the lungs showed moderate emphysema, slight thickening of some alveolar walls and a few asbestosis bodies. The authors called this a minor grade of the disease and questioned whether it caused the patient's emphysema and cough. The second patient, aged 52, had worked about nine months in an asbestos factory in 1921 without precautions against dust. This patient also had tuberculosis, and the authors considered the asbestosis, together with the tuberculosis, the cause of death. Autopsy found diffuse lung fibrosis, marked pleural fibrosis, and asbestos bodies in the lungs, spleen and lymph nodes. The bodies were fewer in the tuberculous caseous areas. The authors concluded that the lung is not the only organ invaded by asbestosis bodies, and that further study on prevention was needed.

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 (two cases)
• Who was studied: Two patients in Philadelphia, 1928 to 1931. Case 1 was a white man admitted to Jefferson Medical College Hospital in June 1931. Case 2, aged 52, was first admitted to a hospital in December 1928 and later to the Jefferson Hospital for Diseases of the Chest.
• Exposure: Asbestos dust; the fiber type was not specified. Case 1 worked nine years as a spinner in an asbestos mill that was not very dusty, wearing dust protectors in the nostrils. Case 2 worked about nine months in an asbestos factory in 1921 with no precautions against inhaling dust; the patient's exact duties could not be determined.
• Main results:
  • Case 1 died of peritonitis after an operation to remove the gallbladder.
  • Case 1: under the microscope the lungs showed moderate emphysema, slight thickening of some alveolar walls, and a few typical asbestosis bodies.
  • Case 1: the authors described this as a minor grade of the disease, despite a well-ventilated factory and the use of precautionary appliances.
  • Case 2: the main lung lesion was diffuse fibrosis, particularly marked in the lower lobes.
  • Case 2: there was marked fibrosis of the pleura, particularly between the base of the lung and the diaphragm, which the authors called characteristic.
  • Case 2: the authors stated that the disease occurred together with tuberculosis and, with it, was the cause of death.
  • Case 2: the asbestos bodies in the lung measured roughly 10 to 20 microns and were golden brown.
  • Case 2: asbestos bodies were fewer in the caseous tuberculous areas of the left lung than in the adjacent lung tissue.
  • Case 2: after an acid-fast stain, the asbestos bodies stained pale green instead of blue but could still be recognized.
  • Case 2: a few large, typical asbestos bodies were found in the spleen. The authors stated that, to their knowledge, this finding had not been reported before.
  • Case 2: a few asbestosis bodies were present in the bronchial lymph nodes.
• The authors' conclusion: The authors concluded that in asbestosis the lung is not the only organ invaded by asbestosis bodies, since the spleen and lymph nodes may harbor them. They also concluded that the histories point to a further need for study on preventing the disease.
• Limitations the authors state:
  • For case 1, the authors stated it was a question whether the asbestosis had anything to do with the patient's emphysema and cough.
  • The authors said they had no evidence on how the asbestos bodies reached the spleen.
  • The exact duties of case 2 in the asbestos factory could not be determined.

Topics

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

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