Electron microscopic studies in desquamative interstitial pneumonia associated with asbestos

Our plain-English summary of Electron microscopic studies in desquamative interstitial pneumonia associated with asbestos, by B. Corrin, A.B. Price (Thorax, 1972).

The study

• Authors: B. Corrin, A.B. Price
• Journal: Thorax
• Published: 1972;27(3):324-31
• Cited by: 62 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A case of desquamative interstitial pneumonia (DIP) has been studied by electron microscopy in order to determine the nature of the alveolar cells. Those lining the alveolar walls proved to be granular pneumocytes (type II alveolar epithelial cells) while cells free in the lumen were alveolar macrophages. The brief literature describing the electron microscopic findings in DIP is reviewed. All workers agree that the lining cells are granular pneumocytes and most report a mixed free cell population with the emphasis shifting from desquamated epithelial cells to macrophages. In the present case asbestos bodies were also found in the lung, suggesting that DIP is not a specific disease entity.

In plain English

This article was a case report with a brief review of earlier electron microscope studies. The authors examined a lung biopsy from a 48-year-old man with breathlessness and joint pain. He worked in a dockyard but had no known direct contact with asbestos. Light microscopy showed desquamative interstitial pneumonia (DIP), a condition in which the lung's air sacs fill with cells. An iron stain revealed scanty ferruginous bodies, which the authors described as probably representing asbestos, and the case was diagnosed as DIP associated with asbestos inhalation. No asbestos bodies were seen on electron microscopy. Under the electron microscope, the cells lining the air sacs were type II (granular) pneumocytes, and the cells lying free in the air spaces were alveolar macrophages. Reviewing published cases, the authors noted that macrophages predominated in five of six well-described cases. Steroids were withheld, and one year later the man was clinically well. The authors concluded that DIP probably results from various harmful influences rather than being a specific disease, though its distinctive pattern warrants separate recognition.

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 a brief review of earlier electron microscope studies of DIP
• Who was studied: one 48-year-old man with a six-month history of increasing breathlessness and joint pain; former smoker of 10 cigarettes per day; seen at hospitals in London and Portsmouth, England
• Exposure: employed in a dockyard with no known direct contact with asbestos; scanty ferruginous bodies, probably representing asbestos, found in the lung biopsy; no fiber type identified
• Main results:
  • An iron (Perls') stain of the biopsy showed scanty ferruginous bodies, which the authors described as probably representing asbestos.
  • The biopsy was diagnosed as DIP associated with asbestos inhalation.
  • No asbestos bodies were found on electron microscopy.
  • Under the electron microscope, the cells lining the alveolar walls were type II (granular) pneumocytes.
  • The cells lying free in the alveolar spaces had the features of alveolar macrophages.
  • In the authors' review of earlier reports, macrophages predominated among the free alveolar cells in five of the six DIP cases whose fine structure had been carefully described and illustrated.
  • Steroids were withheld, and the patient was clinically well one year later.
• The authors' conclusion: The authors concluded that DIP probably represents the result of various noxious influences rather than a specific disease entity. They added that its characteristic histological pattern warrants separate recognition.

Topics

Medical terms in this study, explained in our Lexicon: Interstitial, Alveolar Macrophage, Macrophage, Asbestos Bodies.

Related studies

• Desquamative interstitial pneumonia associated with chrysotile asbestos fibres — J.A. Freed, A. Miller, et al. (1991)
• Desquamative interstitial pneumonitis. Cellular phase of fibrosing alveolitis — R.R. Tubbs, S.P. Benjamin, et al. (1977)
• Desquamative interstitial pneumonia induced by metal exposure. A case report and literature review — T. Blin, A. De Muret, et al. (2020)
• Biphasic malignant mesothelioma with epithelioid and sarcomatoid components (dedifferentiated mesothelioma) and intrapulmonary growth: a rare entity mimicking desquamative interstitial pneumonia — J. Laforga, A. Gonzalez Garcia (2020)
• Electron microscopic findings in the lungs of miners — G. Harrison, N.L. Lapp (1972)
• Imatinib mesylate inhibits fibrogenesis in asbestos-induced interstitial pneumonia — K. Vuorinen, F. Gao, et al. (2007)

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