Letter: Asbestos pleural effusion?

Our plain-English summary of Letter: Asbestos pleural effusion?, by F.M. Hasan (Annals of Internal Medicine, 1975).

The study

• Author: F.M. Hasan
• Journal: Annals of Internal Medicine
• Published: 1975;83(5):735
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M nos. 002326, 002477).

In plain English

This is a short letter to the editor, not a research study. The author wrote about one patient described in an earlier paper by Galen and associates on hemorrhagic pleural effusion (fluid around the lungs containing blood) in patients on long-term hemodialysis. Before receiving heparin, that patient had clear yellow pleural fluid, and her chest X-ray showed bilateral pleural thickening with pleural calcification on the right. The author asked whether this could have been a benign persistent pleural effusion associated with asbestosis. Citing an earlier published report, the author noted that asbestos pleural effusion is a sterile exudate that is usually bilateral. The author suggested that any asbestos dust exposure could have been urban or occupational. The author also cited unpublished data reporting that 3.3 histories are taken before past asbestos exposure is discovered. No fiber type or exposure measurement was given. In a published reply, Lowrie, one of the original paper's authors, stated that the patient had worked as a bookkeeper her entire life, that no history of asbestos exposure was recorded in her chart, and that she had died and an autopsy was denied by the family.

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: Letter to the editor commenting on a single patient from another group's published paper; no new data collected
• Who was studied: One uremic patient on chronic hemodialysis described in the paper by Galen and associates (Ann Intern Med 1975), who had a pleural effusion; a bookkeeper, according to the published reply
• Exposure: Possible, unconfirmed exposure to asbestos dust, which the author suggested could have been urban or occupational; no fiber type, product, job or dose given
• Main results:
  • The patient in the Galen paper had a chest X-ray showing bilateral pleural thickening with pleural calcification on the right, as quoted by the author
  • The author cited unpublished data (Hasan, Nash and Kazemi) reporting that 3.3 histories are taken before past asbestos exposure is discovered; no further details of those data are given
  • In the reply, Lowrie stated that the patient worked as a bookkeeper her entire life
  • In the reply, Lowrie stated that no history of asbestos exposure was recorded in the patient's chart
  • In the reply, Lowrie stated that the patient had died and that postmortem examination was denied by the family
• The authors' conclusion: The author did not reach a conclusion. The author raised the question of whether the patient's effusion was a benign persistent pleural effusion associated with asbestosis

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleural Effusion.

Related studies

• Etiology of pleural effusions: analysis of more than 3,000 consecutive thoracenteses — J.M. Porcel, A. Esquerda, et al. (2014)
• Pleural effusion: laboratory tests in 300 cases — A. Hirsch, P. Ruffie, et al. (1979)
• The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: the role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen — E.S. Cibas, J.M. Corson, et al. (1987)
• Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial — M. Metintas, G. Ak, et al. (2010)
• Diagnostic problems in serous effusions — C.W. Bedrossian (1998)
• Use of antisera to epithelial membrane antigen for the cytodiagnosis of malignancy in serous effusions — A. To, D.V. Coleman, et al. (1981)

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