Relationship between number of asbestos bodies in autopsy lung and pleural plaques on chest X-ray film

Our plain-English summary of Relationship between number of asbestos bodies in autopsy lung and pleural plaques on chest X-ray film, by T. Kishimoto, T. Ono, K. Okada, et al (Chest, 1989).

The study

• Authors: T. Kishimoto, T. Ono, K. Okada, H. Ito
• Journal: Chest
• Published: 1989;95(3):549-52
• Cited by: 17 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. 000108).

Abstract

We investigated the relationship between number of asbestos bodies and pleural plaques. Using sodium hypochrolite, we examined 400 autopsy lungs and could detect 71 cases whose asbestos bodies were significantly high. We checked pleural plaques on chest x-ray films of these 71 cases and compared the exact plaque at autopsy. By the criteria of Askergren and Szamosi, we classified these into three groups (probable, definite, definite with calcification). This classification is consistent with the pleural plaques found at autopsy. Cases whose pleural plaques were definite (thick) had many more asbestos bodies than indefinite cases. As for occupational histories, there were 23 cases who worked in Japanese Naval shipyards before and during World War II, 14 others in various shipyards, and 14 others who also had a history of asbestos exposure. These 51 patients died more than 30 years after the first asbestos exposure. Twenty had no definite asbestos exposure.

In plain English

This autopsy study examined lungs from 400 patients autopsied at Kure Kyosai Hospital, Japan, from 1984 through 1986. The authors dissolved 5 g of lung tissue and counted asbestos bodies by light microscopy. Seventy-one cases had more than 500 asbestos bodies per 5 g; 49 had malignancies, including nine malignant mesotheliomas and 15 lung cancers. Fifty-one of the 71 had worked in shipyards or had other asbestos exposure; 20 had no definite exposure history. On chest x-ray film, 24 showed probable pleural plaque (type IIIb), 22 definite plaque (type IV) and 25 definite plaque with calcification (type V). Asbestos body figures were 960 plus or minus 104 for type IIIb, 32,560 plus or minus 31,346 for type IV and 42,841 plus or minus 10,981 for type V. Type IIIb differed from types IV and V with p less than 0.01. Autopsy found some pleural plaque in all 71 cases. The authors concluded that cases with clear plaques on x-ray had many more asbestos bodies than unclear cases. They noted that about 20 unclear exposure histories prevented a full analysis of time since first exposure.

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: Autopsy study: asbestos bodies were counted in lung tissue, and the counts were compared with pleural plaque grades on chest x-ray film and with plaques found at autopsy
• Who was studied: 400 patients autopsied at Kure Kyosai Hospital, Kure, Japan, from 1984 through 1986 (200 with malignancies, 200 with benign diseases). Of these, 71 had more than 500 asbestos bodies per 5 g of lung tissue and were studied further (61 men, 10 women).
• Exposure: Asbestos, with fiber type not specified, measured as asbestos bodies in lung tissue. Occupational histories included work in Japanese Naval shipyards before and during World War II, work in other shipyards, and other asbestos-exposed jobs.
• Main results:
  • 71 of the 400 autopsied cases had more than 500 asbestos bodies in 5 g of lung tissue. The article states this as 17.5 percent of total cases.
  • Of the 71 cases, 49 had malignancies and 22 had benign diseases.
  • Among the 71 cases' malignancies there were nine malignant mesotheliomas (given as 100 percent), 15 lung cancers (32.5 percent), and seven each of stomach cancer (20 percent) and liver cancer (24 percent).
  • Among the 71 cases, 23 had worked in Japanese Naval shipyards, 14 in other shipyards, and 14 had other asbestos exposure. These 51 died at least 30 years after first asbestos exposure.
  • All the malignant mesothelioma cases had worked in shipyards.
  • Twenty of the 71 cases had no definite history of asbestos exposure.
  • On chest x-ray film (Askergren and Szamosi criteria), 24 cases were type IIIb (probable pleural plaque), 22 type IV (definite pleural plaque), and 25 type V (definite pleural plaque with calcifications).
  • Asbestos body figures by plaque type were 960 plus or minus 104 for type IIIb, 32,560 plus or minus 31,346 for type IV, and 42,841 plus or minus 10,981 for type V.
  • The difference between type IIIb and type IV or type V was reported with p less than 0.01.
  • At autopsy, some type of pleural plaque was found in all 71 cases. The authors reported that the chest x-ray findings were consistent with the autopsy findings.
  • Cases with a Japanese Naval shipyard work history died more than 40 years after first asbestos exposure.
• The authors' conclusion: The authors concluded that cases with clear (definite) pleural plaques on chest x-ray film had many more asbestos bodies than unclear cases. They also concluded that the x-ray classification matched the plaques found at autopsy.
• Limitations the authors state:
  • The authors could not fully examine how time since first asbestos exposure related to pleural plaques or asbestos body counts, because about 20 cases had unclear exposure histories.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Bodies, Autopsy, Pleural Plaques, Chest X-Ray, Asbestos Exposure.

Related studies

• Coated and uncoated lung mineral fibres in subjects with and without pleural plaques at autopsy — A. Andrion, D. Bellis, et al. (1984)
• Significant relationship between the extent of pleural plaques and pulmonary asbestos body concentration in lung cancer patients with occupational asbestos exposure — T. Yusa, K. Hiroshima, et al. (2015)
• Asbestos bodies and pleural plaques in human lungs at necropsy — I. Hägerstrand, B. Seifert (1973)
• Asbestos bodies in human lungs at autopsy — D. Cauna, R.S. Totten, et al. (1965)
• Risk and significance of chest radiograph and pulmonary function abnormalities in an elderly cohort of former nuclear weapons workers — M.A. Mikulski, P.G. Hartley, et al. (2011)
• Diffusing capacity and forced vital capacity in 5,003 asbestos-exposed workers: relationships to interstitial fibrosis (ILO profusion score) and pleural thickening — A. Miller, R. Warshaw, et al. (2013)

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