Pleural mesothelioma in a woman whose documented past exposure to asbestos was from smoking asbestos-containing filtered cigarettes: the comparative value of analytical transmission electron microscopic analysis of lung and lymph-node tissue

Our plain-English summary of Pleural mesothelioma in a woman whose documented past exposure to asbestos was from smoking asbestos-containing filtered cigarettes: the comparative value of analytical transmission electron microscopic analysis of lung and lymph-node tissue, by R.F. Dodson, S.P. Hammar (Inhalation Toxicology, 2006).

The study

• Authors: R.F. Dodson, S.P. Hammar
• Journal: Inhalation Toxicology
• Published: 2006;18(9):679-84
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos has had many commercial applications, including its use as a major component in various types of filters. Between 1952 and 1956, crocidolite asbestos was used as a component of filters for cigarettes, reportedly greatly reducing tars and nicotine from mainstream smoke. This case report quantifies asbestos burden in lung and lymph node tissue in a 67-yr-old woman who succumbed to mesothelioma. Her only historically documented exposure to asbestos was from smoking crocidolite asbestos-containing filtered cigarettes between 1952 and 1956. Tissue digestion analysis by analytical transmission electron microscopy (ATEM) identified crocidolite fibers in lungs and thoracic lymph nodes. Combined ATEM data of lung and lymph node tissue clarified the patient's exposure to asbestos and particularly to crocidolite asbestos and thus to the presence of an entity recognized as the causal agent for mesothelioma.

In plain English

This case report described a 67-year-old homemaker who died of left pleural mesothelioma. Her only known asbestos exposure was smoking, between 1952 and 1956, a cigarette brand whose filters contained crocidolite asbestos. The authors examined autopsy lung and thoracic lymph-node tissue by light and electron microscopy. Light microscopy showed no asbestos bodies in either lung and one in the lymph nodes; electron microscopy also found a 20-micrometre crocidolite-cored asbestos body there. The left lung contained five asbestos fibers (amosite, tremolite, crocidolite, anthophyllite and chrysotile), equal to 20,018 fibers per gram of wet tissue. The right lung contained four, equal to 16,021 per gram wet. The lymph nodes held 22 amphibole asbestos fibers, 10 of them crocidolite, equal to 2,562,526 fibers per gram wet. The two crocidolite fibers in the lungs were 8.8 and 6.6 micrometres long. The authors noted that a count limited to longer, thicker fibers would have suggested little or no crocidolite. They concluded it was reasonable to assume the crocidolite came from the cigarettes, and that lymph nodes add information beyond lung tissue.

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 (tissue fiber-burden analysis of one autopsy case)
• Who was studied: One 67-year-old woman, a lifelong homemaker, diagnosed with left pleural mesothelioma in February 1996, who died in July 1997. At autopsy the tumor was a predominantly epithelial, biphasic mesothelioma. No pleural plaques were seen and no asbestos bodies were found in iron-stained lung sections.
• Exposure: Smoking, between 1952 and 1956, a cigarette brand whose filters contained crocidolite asbestos. The authors described this as her only known asbestos exposure.
• Main results:
  • No asbestos (ferruginous) bodies were found by light microscopy in the left or right lung digests, within the limits of detection.
  • One asbestos body was found by light microscopy in the lymph-node digest, equivalent to 233 asbestos bodies per gram wet tissue (1290 per gram dry).
  • A crocidolite-cored asbestos body, 20 micrometres long, was also found on electron-microscopy grids prepared from the lymph-node digest.
  • Left lung: of 12 fibers seen, five were asbestos (one each of amosite, tremolite, crocidolite, anthophyllite and chrysotile).
  • Left lung: the five asbestos fibers equalled 20,018 fibers per gram wet tissue (105,827 per gram dry).
  • Right lung: of 11 fibers seen, 4 were amphibole asbestos (two tremolite, one crocidolite, one anthophyllite), equal to 16,021 fibers per gram wet tissue (88,838 per gram dry).
  • Lymph nodes: of 101 fibers seen, 22 were amphibole asbestos (10 crocidolite, 8 tremolite, 4 anthophyllite).
  • Lymph nodes: the 22 asbestos fibers equalled 2,562,526 fibers per gram wet tissue (14,319,998 per gram dry).
  • The crocidolite fibers found in the two lung samples were 8.8 micrometres and 6.6 micrometres long.
  • Average asbestos fiber length was 6.28 micrometres in the left lung, 7.45 micrometres in the right lung and 4.12 micrometres in the lymph nodes.
  • The authors applied counting rules limited to longer fibers and the diameter detection limits of scanning electron microscopy. Under those rules, they estimated that only 1 of the 10 crocidolite fibers and 2 of the 8 tremolite fibers in the lymph nodes would have been counted.
  • Fibrous talc was found in all samples, which the authors took as indicating past talc exposure.
• The authors' conclusion: The authors concluded that, because no other crocidolite exposure was identified, it seemed reasonable to assume the exposure came from smoking crocidolite-containing filtered cigarettes. They also concluded that lymph nodes draining the lung may add useful information beyond analysis of lung tissue alone.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Crocidolite, Mesothelioma, Tissue Digestion, Analytical Transmission Electron Microscopy (ATEM).

Related studies

• Asbestos content of lung tissue, lymph nodes, and pleural plaques from former shipyard workers — R.F. Dodson, M.G. Williams, et al. (1990)
• Characteristics of asbestos concentration in lung as compared to asbestos concentration in various levels of lymph nodes that collect drainage from the lung — R.F. Dodson, S. Shepherd, et al. (2007)
• A comparison of asbestos burden in lung parenchyma, lymph nodes, and plaques — R.F. Dodson, M.G. Williams, et al. (1991)
• Asbestos fibers in para-aortic and mesenteric lymph nodes — T. Uibu, E. Vanhala, et al. (2009)
• Extrapleural and cardiophrenic lymph nodes: prevalence, clinical significance and diagnostic value — B. Feragalli, C. Mantini, et al. (2014)
• Intrapulmonary lymph nodes. Clinical, radiologic, and pathologic features — R.L. Kradin, P.W. Spirn, et al. (1985)

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