Pulmonary asbestosis associated to pleural non-Hodgkin lymphoma

Our plain-English summary of Pulmonary asbestosis associated to pleural non-Hodgkin lymphoma, by E. Parisio, C. Bianchi, R. Rovej, et al (Tumori, 1999).

The study

• Authors: E. Parisio, C. Bianchi, R. Rovej, F. Sparacio, A. Ferrari, A. Scanni
• Journal: Tumori
• Published: 1999;85(1):75-7
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We describe herein a case report of a patient affected by pulmonary asbestosis who developed a non-Hodgkin lymphoma originating in the pleura. The case is unusual for the uncommon site and because the chronic antigenic stimulation by asbestos bodies may have locally promoted an immunologic derangement.

In plain English

This article was a case report of one patient at the Ospedale Fatebenefratelli in Milan, Italy. In August 1994, a 75-year-old man was admitted. A chest X-ray showed fluid around the left lung and thickening and calcification of the pleura on both sides. A pleural biopsy confirmed a large B cell non-Hodgkin lymphoma, and scans found it only in the pleura. After 9 cycles of chemotherapy he was in complete remission, but he relapsed in December 1996. He later reported 9 years as a warship gunner, before and during World War II, wearing what the article calls "amiantus" (asbestos) gloves. He later worked as a fireman. No fiber type was named. Washing fluid from his lungs contained several uncoated fibers and one asbestos body. His blood showed below-normal T cell and above-normal B cell percentages. The authors concluded that his asbestos exposure was probably responsible for a derangement of his immune response. They said his low T lymphocyte levels, particularly of T suppressor cells, in blood and pleural fluid had never been reported before and needed confirmation in a larger study.

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)
• Who was studied: One 75-year-old male patient admitted in August 1994 to the Ospedale Fatebenefratelli, Milan, Italy, with pulmonary asbestosis and non-Hodgkin lymphoma originating in the pleura
• Exposure: Nine years as a gunner on a warship before and during World War II, wearing 'amiantus' (asbestos) gloves; later worked as a fireman. No fiber type was identified.
• Main results:
  • Chest X-ray on admission showed left pleural effusion, bilateral pleural thickening and calcifications
  • Pleural biopsy confirmed a large B cell non-Hodgkin lymphoma; staging CT showed pleural involvement without any other site
  • In the patient's blood, lymphocyte subgroups were 45% T3 (normal 64-77%), 28% T4 (normal 34-52%), 16% T8 (normal 22-35%) and 39% total B cells (normal 8-16%)
  • In the pleural fluid, subpopulations were 37% T3, 29% T4, 5% T8 and 63% B lymphocytes
  • Throughout clinical observation the patient consistently showed a reduced T lymphocyte concentration, particularly of T suppressor lymphocytes, in blood and in pleural fluid
  • After 9 cycles of CEOP chemotherapy the patient was in complete remission
  • The patient relapsed in December 1996 after 18 months of follow-up; a cervical node biopsy confirmed large B cell lymphoma and bone marrow biopsy was positive
  • Bronchoalveolar lavage showed several uncoated fibers and an asbestos body
  • Pulmonary function tests showed a high-grade restrictive syndrome and a severe reduction in DLCO
  • During the second course of chemotherapy the patient developed pneumococcal sepsis and hypergammaglobulinemia (48.6%) with an IgGk monoclonal component; at the time of writing he had a partial remission greater than 75%
• The authors' conclusion: The authors concluded that in this patient the asbestos exposure was probably responsible for derangement of the immune response
• Limitations the authors state:
  • The authors stated that their finding of reduced T lymphocytes, particularly T suppressor cells, in blood and pleural fluid had never previously been reported in the literature and should be confirmed by a larger study

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestosis, Pleura, Asbestos Bodies.

Related studies

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• A death-certificate case-control study of non-Hodgkin's lymphoma and occupation in men in North Carolina — M.C. Schumacher, E. Delzell (1988)
• Clinicopathologic characteristics of malignant mesotheliomas arising in patients with a history of radiation for Hodgkin and non-Hodgkin lymphoma — L.R. Chirieac, J.A. Barletta, et al. (2013)
• Does asbestos exposure cause non-Hodgkin's lymphoma or related hematolymphoid cancers? A review of the epidemiologic literature — D.D. Weisenburger, B.C. Chiu (2002)
• Occupational asbestos exposure and the incidence of non-Hodgkin lymphoma of the gastrointestinal tract: an ecologic study — M.M. Treggiari, N.S. Weiss (2004)

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