Histology of Pulmonary Asbestosis

Our plain-English summary of Histology of Pulmonary Asbestosis, by S. McDonald (British Medical Journal, 1927).

The study

• Author: S. McDonald
• Journal: British Medical Journal
• Published: 1927;2(3491):1025-6
• Cited by: 46 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003118).

In plain English

This article reported a microscopic study of lung tissue from one patient with pulmonary asbestosis, the case described by Dr. Cooke. The author said sections from a second case, supplied by Dr. Grieve of Armley, Leeds, looked practically identical. The patient had worked with Canadian serpentine (chrysotile) asbestos. Sections from both lungs showed diffuse interstitial pneumonia with chronic bronchitis and some emphysema, anthracosis, and an extensive tuberculous condition, with changes more marked on the right side. Abundant small yellowish-brown bodies, mostly 20 to 70 microns long, were found in the air sacs, inside scavenger cells, and in scarred and caseous areas. They gave a Prussian-blue colour reaction in a chemical test. Zoologists judged them not animal, and the general opinion of botanical and chemical experts was that they were not plant forms. The author proposed that they were asbestos fibres slowly altered by chemical breakdown. The author found it difficult to say how much of the scarring came from asbestos and how much from tuberculosis. The author concluded that the bodies' nature remained in doubt until experiments were done, but that they might prove a diagnostic sign of an asbestos worker's lung.

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: Microscopic (histological) examination of lung tissue from one case of pulmonary asbestosis, compared with sections from a second case
• Who was studied: Lung sections from the patient described by Dr. Cooke, plus sections from a second case lent by Dr. T. M. D. Grieve of Armley, Leeds (England)
• Exposure: Occupational work with Canadian serpentine (chrysotile) asbestos
• Main results:
  • Both lungs showed diffuse interstitial pneumonia with chronic bronchitis and some emphysema; changes were more marked on the right side
  • There was marked anthracosis
  • There was an extensive tuberculous condition with chronic phthisis; tubercle bacilli were not detected, but the author judged the histology characteristic
  • The whorled formations typical of a more purely silicotic condition were not present
  • Abundant small foreign bodies, many taken up by large mononuclear cells in the alveoli, measured about 20 to 70 microns, or more for some elongated forms
  • The bodies gave a characteristic Prussian-blue reaction with potassium ferrocyanide and dilute hydrochloric acid
  • Zoology experts were unanimous that the bodies were not of animal nature
  • Botanical and chemical authorities differed, but their general opinion was that the bodies were not plant forms
  • Exactly similar bodies had been found in the lungs of another asbestos worker
  • The author hypothesized that the bodies were portions of asbestos fibres being altered and absorbed by hydrolysis
  • In Dr. Grieve's case, the sections showed considerable fibrosis without apparent tuberculosis
• The authors' conclusion: The authors concluded that the exact nature of the bodies must remain in doubt until experimental work is done, but that their characteristic appearance may prove a diagnostic point in recognizing the lung of an asbestos worker
• Limitations the authors state:
  • The author found it difficult to say how much of the fibrosis was due to asbestos and how much to the tuberculous infection
  • Examination with the micro-spectroscope had given no clue to the nature of the bodies
  • The hydrolysis explanation is a hypothesis that still needs experimental verification

Topics

Medical terms in this study, explained in our Lexicon: Histology, Asbestosis.

Related studies

• Inhibition of lung injury, inflammation, and interstitial pulmonary fibrosis by polyethylene glycol-conjugated catalase in a rapid inhalation model of asbestosis — B.T. Mossman, J.P. Marsh, et al. (1990)
• Pulmonary endpoints (lung carcinomas and asbestosis) following inhalation exposure to asbestos — B.T. Mossman, M. Lippmann, et al. (2011)
• Pulmonary Asbestosis — W.E. Cooke (1927)
• Pulmonary asbestosis: CT study of subpleural curvilinear shadow. Work in progress — H. Yoshimura, M. Hatakeyama, et al. (1986)
• Experimental asbestosis. The development of lung cancer in rats with pulmonary deposits of chrysotile asbestos dust — P. Gross, R.T. DeTreville, et al. (1967)
• Chrysotile-induced asbestosis: changes in the free cell population, pulmonary surfactant and whole lung tissue of rats — T.D. Tetley, P.M. Hext, et al. (1976)

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