Malignant mesothelioma with minimal asbestos exposure

Our plain-English summary of Malignant mesothelioma with minimal asbestos exposure, by W.J. Chen, N.K. Mottet (Human Pathology, 1978).

The study

• Authors: W.J. Chen, N.K. Mottet
• Journal: Human Pathology
• Published: 1978;9(3):253-8
• Type of article: Case report
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001069).

Abstract

The association of malignant mesothelioma and asbestos fibers is well established. The minimal exposure that may produce the tumor is not known. The present report documents the minimal exposure by thorough examination of occupational history and personal hobbies, and counting of the number of asbestos fibers in the lungs. The evidence for the elemental composition of asbestos fibers by electron probe (EDAX) is also presented.

In plain English

This article was a case report of one man, a 59-year-old white nonsmoker whose symptoms began in July 1975 and who died 10 months later. Tumor covered the lining around his right lung. A biopsy was first reported as large cell undifferentiated carcinoma. At autopsy the tumor showed epithelial and mesenchymal patterns, which the authors described as characteristic of malignant mesothelioma. His wife gave a history of his life. He was an engineer and executive at a building materials firm and later at a fiberglass firm. He occasionally inspected construction sites but did not personally handle building materials. The authors counted an average of 168 fibers per 5-gram lung sample, 14 times an age-matched control figure of 12 per 5 grams. Assuming both lungs weighed 1500 grams, they estimated about 50,400 fibers in the lungs. Assuming 20 years of exposure, that came to about 2520 fibers accumulated per year. Electron probe analysis found silicon, magnesium and calcium in fiber cores, with iron mainly in the beaded coating. The authors called these elements characteristic of asbestos but did not name a fiber type. They concluded that minimal exposure to asbestos can cause mesothelioma.

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 (one patient), with lung fiber counts and electron probe (EDAX) analysis of asbestos bodies
• Who was studied: one 59-year-old white male nonsmoker, treated and autopsied at institutions in Seattle, Washington; symptoms began July 1975 and he died 10 months after onset
• Exposure: Described by the authors as casual and minimal. He was an engineer, then an executive at a building materials firm and, for his last six years, at a fiberglass firm. He occasionally inspected major construction sites but did not personally handle building materials. He did no home workshop or do-it-yourself work. The fiber type was not named.
• Main results:
  • The biopsy was first reported as large cell undifferentiated carcinoma. Autopsy tumor sections from the right pleura showed epithelial and mesenchymal patterns, described as characteristic of malignant mesothelioma.
  • The patient's lungs held an average of 168 fibers per 5 gram sample (multiple samples from both lungs).
  • The patient's count was 14 times higher than an age-matched control figure (12 per 5 gm.). The article does not describe where this control figure came from.
  • The patient's count was about six times higher than the mean (28.6 per 5 gm.) in a control population reported by Bhagavan and Koss.
  • Assuming both lungs weighed 1500 gm., the authors estimated about 50,400 fibers in the lungs. Separately assuming 20 years of exposure, they estimated about 2520 fibers accumulated per year.
  • Electron probe analysis found Mg, Si and Ca with minimal iron in the fiber core, and a large amount of iron in the beaded coating. The authors described these elements as characteristic of asbestos.
• The authors' conclusion: The authors concluded that this case illustrates that minimal exposure to asbestos can cause mesothelioma. They also suggested that diminished clearance of fibers from the lungs may have been important in this patient.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Exposure, Occupational History.

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