Asymmetric rapidly progressive lung fibrosis: a cause of pseudotumour in asbestosis

Our plain-English summary of Asymmetric rapidly progressive lung fibrosis: a cause of pseudotumour in asbestosis, by W.O. Cookson, J.J. Glancy, F.A. Frost (British Journal of Industrial Medicine, 1985).

The study

• Authors: W.O. Cookson, J.J. Glancy, F.A. Frost
• Journal: British Journal of Industrial Medicine
• Published: 1985;42(5):350-3
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001226).

In plain English

This short article is a case report from Sir Charles Gairdner Hospital in Perth, Western Australia. It describes one man whose lung scarring looked like cancer on X-rays. The 38 year old man had worked for 12 months in the crocidolite mill at Wittenoom Gorge 18 years before he came to the hospital. A chest X-ray five years before that visit had first shown silicoasbestosis, and he had smoked 20 cigarettes a day since age 18. Over repeated X-rays, shadows in both upper lungs gave way to a growing mass on one side, in the right upper lobe. Because the mass looked like possible lung cancer, surgeons removed that lobe, which had shrunk to the size of a cricket ball. Under the microscope it showed scarring, some silica particles and many ferruginous (asbestos) bodies, with no evidence of cancer. The changes were attributed to silicoasbestosis. The authors concluded that asymmetric progressive massive fibrosis of an upper lobe should be considered as another cause of apparent malignancy in people with asbestos-related lung fibrosis, particularly with added silica exposure.

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 patient)
• Who was studied: One 38 year old man investigated for an enlarging shadow in the right upper lobe of the lung, at Sir Charles Gairdner Hospital, Perth, Western Australia; dates of care not given
• Exposure: 12 months of work in the crocidolite mill at Wittenoom Gorge, Western Australia, 18 years before presentation. The authors state his exposure was mainly to asbestos fibre, with some silica dust. He also smoked 20 cigarettes a day from age 18.
• Main results:
  • On serial chest X-rays, shadows that were at first similar in both upper lobes were followed by a growing, clearly one-sided mass in the right upper lobe
  • A needle aspiration biopsy showed asbestos bodies among other cells and debris
  • At surgery the right upper lobe was shrunken and scarred, about the size of a cricket ball, and was removed
  • Under the microscope the removed lobe showed many ferruginous bodies trapped in scar tissue, along with some silica particles
  • No cancer was found; the changes were attributed to silicoasbestosis
  • The lung's transfer factor for carbon monoxide was 16.5 ml/min/mm Hg, against a predicted 30.9 ml/min/mm Hg, a deficit the authors took as showing asbestosis
• The authors' conclusion: The authors concluded that asymmetric progressive massive fibrosis of an upper lobe should be considered as another cause of apparent malignancy when large X-ray shadows appear in patients with asbestos-related pulmonary fibrosis, particularly if they were also exposed to silica.

Mines named here

Asbestos mines this study is about. Each mine's page says who ran it, when it worked, and what it produced.

• Wittenoom, Western Australia

All asbestos mines

Topics

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

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

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