Lymphoid and plasma cell malignancies: asbestos-related disorders of long latency

Our plain-English summary of Lymphoid and plasma cell malignancies: asbestos-related disorders of long latency, by E. Kagan, R.J. Jacobson (American Journal of Clinical Pathology, 1983).

The study

• Authors: E. Kagan, R.J. Jacobson
• Journal: American Journal of Clinical Pathology
• Published: 1983;80(1):14-20
• Cited by: 49 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We have identified 13 asbestos workers with lymphoplasmacytic neoplasms: six with chronic lymphocytic leukemia, four with IgG myeloma, two with IgA myeloma, and one with histiocytic lymphoma. The subjects' occupations were varied, but all had experienced protracted asbestos exposure (ranging from 3-37 years). Tumor latency periods were similar to other known asbestos-related malignancies and ranged from 16-41 years. Stigmata of asbestos-related pulmonary disease were evident in 12 subjects. Malignant pleural mesotheliomas co-existed with IgG myelomas in two individuals, an association which seems unlikely to be fortuitous. It has been speculated previously that asbestos may be a lymphoid system carcinogen. Our findings strongly support this view and indicate that patients presenting de novo with lymphoproliferative neoplasms should be investigated for previous occupational or environmental exposure to asbestos.

In plain English

This article was a case series describing 13 male asbestos workers in the United States who had cancers of lymphoid or plasma cells. Ten had been referred to the authors for blood-disease evaluation, and three had been reported earlier. Six had myeloma (four IgG, two IgA), six had chronic lymphocytic leukemia, and one had histiocytic lymphoma of the lung. They had worked with asbestos for 3 to 37 years (mean 22.8). One was exposed only to amosite, one only to chrysotile, and one to chrysotile, crocidolite and amosite. All but one showed asbestos-related lung or pleural disease. The time from first exposure to diagnosis averaged 30.2 years for both the myeloma and the leukemia cases. Two men had malignant pleural mesothelioma as well as IgG myeloma, which the authors judged unlikely to be chance. The authors wrote that their findings strongly support the idea that asbestos may be a lymphoid system carcinogen. They also said they could not tell whether these cancers occurred more often than expected, and they called for large-scale epidemiologic studies.

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 series (13 cases)
• Who was studied: 13 male asbestos workers with lymphoid or plasma cell cancers. Three had been reported previously by the authors and ten were referred by other physicians from widely differing regions of the United States. Study dates are not given.
• Exposure: Occupational asbestos exposure lasting 3 to 37 years (mean 22.8 years). Jobs included shipyard insulator, pipe lagger, brake lining work, and amosite mining and asbestos milling. Five men were also exposed to other materials (quartz dust, coal dust, fiberglass, organic solvents).
• Main results:
  • Fiber types varied: patient 1 was exposed only to amosite, patient 2 only to chrysotile, and patient 8 to chrysotile, crocidolite and amosite.
  • Signs of asbestos-related lung or pleural disease were found in 12 of the 13 men.
  • Among the 13 men, parenchymal asbestosis was seen in nine and pleural plaques in four. One had bronchogenic adenocarcinoma and two had malignant pleural mesotheliomas.
  • In the six myeloma cases, the serum M-component was IgG in four and IgA in two.
  • In the six myeloma cases, age at diagnosis ranged from 54 to 72 years (mean 65.0). The time from first asbestos exposure to diagnosis ranged from 21 to 37 years (mean 30.2).
  • In the six chronic lymphocytic leukemia cases, age at diagnosis ranged from 50 to 62 years (mean 57.7). The time from first asbestos exposure to diagnosis ranged from 16 to 41 years (mean 30.2).
  • Two men (patients 2 and 4) had both malignant pleural mesothelioma and IgG myeloma.
  • In the histiocytic lymphoma case (patient 13), the lung tumor tissue contained 521 ferruginous bodies per gram of wet lung. This tumor was diagnosed 35 years after first asbestos exposure.
  • Smoking status: four men were non-smokers, seven were regular cigarette smokers and one was an ex-smoker (one man's status was listed as unknown in Table 1).
• The authors' conclusion: The authors concluded that their findings strongly support earlier speculation that asbestos may be a lymphoid system carcinogen. They also judged the two cases of myeloma together with mesothelioma unlikely to be chance.
• Limitations the authors state:
  • Because most cases were referrals from widely differing parts of the United States, the authors could not determine whether these cancers occurred more often than expected in the general population.
  • Airborne asbestos levels were not monitored at the workplaces, so the severity of exposure could not be reliably assessed.
  • There was no information on ferruginous body or asbestos content of the affected blood-forming organs in the myeloma and leukemia cases.
  • The number of cases was too small to draw conclusions about cigarette smoking as a possible cofactor.
  • The observations were based on selected cases. The authors said large-scale epidemiologic studies are needed to determine whether a causal link exists.

Topics

Medical terms in this study, explained in our Lexicon: Latency, Neoplasm, Myeloma, Asbestos Exposure, Pleural Mesothelioma, De Novo, Environmental Exposure.

Related studies

• Asbestos-associated neoplasms of B cell lineage — E. Kagan, R.J. Jacobson, et al. (1979)
• Plasma cell myeloma presenting with diffuse pleural involvement: a hitherto unreported pattern of a new mesothelioma mimicker — A. Colonna, G. Gualco, et al. (2010)
• Newly discovered quick, non-invasive screening method of bone marrow malignancies including various leukemias, Hodgkin's lymphoma, non-Hodgkin's lymphoma, & multiple myeloma by abnormality of small rectangular area within bone marrow organ representation areas of the face — Y. Omura, B. O'Young, et al. (2012)
• Chest physician-reported, work-related, long-latency respiratory disease in Great Britain — M. Carder, A. Darnton, et al. (2017)
• Pulmonary crystal-storing histiocytoma in a patient without a lymphoproliferative disorder — W.S. Lee, S.R. Kim, et al. (2009)
• B cell neoplasms and occupational asbestos exposure — D.A. Schwartz, T.L. Vaughan, et al. (1988)

Browse more research in American Journal of Clinical Pathology, or return to medical research.