Round atelectasis and Metsovo lung

Our plain-English summary of Round atelectasis and Metsovo lung, by S.A. Papiris, M.A. Maniati, K. Sakellariou, et al (Chest, 1993).

The study

• Authors: S.A. Papiris, M.A. Maniati, K. Sakellariou, C. Gosios, D. Kontogiannis, S.H. Constantopoulos
• Journal: Chest
• Published: 1993;103(6):1759-62
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Round (helical) atelectasis is one of the benign sequelae of occupational asbestos exposure. Environmental asbestos exposure does not differ from occupational in its pleural manifestations, but to our knowledge, round atelectasis has not been reported yet. In the present study, we present the clinical and radiologic findings of five individuals with round atelectasis. They were all born in the Metsovo area, northwest Greece, where environmental exposure to asbestos (tremolite) has been documented. All five had negative evaluation for malignancy. In addition, they have been followed up for one to four years and four of them are in good health, thus confirming round atelectasis as a benign, nonpremalignant condition. The fifth patient died of malignant pleural mesothelioma two years later, while the previously detected round atelectasis remained unchanged. We therefore consider that his mesothelioma was not related to the round atelectasis, although both were certainly related to the same environmental asbestos exposure.

In plain English

This retrospective case series described five people born in the Metsovo area of northwest Greece, where residents were exposed to tremolite asbestos from a whitewash used on house walls. The three men and two women, aged 54 to 70, were evaluated at Ioannina University Hospital between 1987 and 1991 for a "pulmonary mass." None had occupational asbestos exposure, but all had used the whitewash for 15 to 65 years. Their work-up for cancer was negative. Their chest radiographs and CT scans suggested round atelectasis, a benign, mass-like area of collapsed lung. Three patients had most of its classic features and two had only some. One patient had two such lesions. Over one to four years of follow-up, four patients were in good health and their radiographs were unchanged. One patient (patient 3) died of malignant pleural mesothelioma two years later, and CT showed no change in his round atelectasis. The authors concluded that the round atelectasis was most likely a result of tremolite exposure and that the mesothelioma was not related to it. They added round atelectasis to the known effects of nonoccupational asbestos 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: Retrospective case series of five patients (clinical and radiologic description) with follow-up
• Who was studied: Five people (three men, two women, aged 54 to 70) born in Metsovo, northwest Greece, evaluated for a "pulmonary mass" at the Pulmonary Department of Ioannina University Hospital between 1987 and 1991. Four still lived in Metsovo; one had left at age 20 and was evaluated 34 years later.
• Exposure: Nonoccupational (environmental) exposure to tremolite asbestos from "Metsovo whitewash", used for 15 to 65 years and stopped 5 to 50 years before evaluation; no occupational asbestos exposure
• Main results:
  • All five patients had a negative work-up for malignancy, and their "mass" showed many features of round atelectasis on imaging
  • Three patients (patients 1, 2 and 3) had most of the classical features of round atelectasis; two (patients 4 and 5) had only some
  • Patient 4 had two lesions compatible with round atelectasis in the right lung
  • Only one of the five patients complained of shortness of breath on exertion; the other four had no symptoms
  • Only patient 1 had another medical history (possible Dressler's syndrome after heart surgery) that could explain the round atelectasis, but this patient also had calcified pleural plaques
  • Over one to four years of follow-up, four patients were in good health with unchanged chest radiographs
  • Patient 3 died of malignant pleural mesothelioma two years later; CT showed no change in the round atelectasis
  • Patient 5, whose findings were atypical, was offered a percutaneous biopsy but declined
• The authors' conclusion: The authors concluded that round atelectasis in these patients was most likely a result of tremolite exposure. They considered the mesothelioma unrelated to the round atelectasis, although both were related to the same environmental asbestos exposure. They also concluded that the results add round atelectasis to the manifestations of nonoccupational asbestos exposure, with most probably no differences from occupational exposure if the fiber is the same.

Topics

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

Medical terms in this study, explained in our Lexicon: Atelectasis, Metsovo Lung, Asbestos Exposure, Environmental Exposure, Tremolite, Pleural Mesothelioma, Mesothelioma.

Related studies

• Causative factors, imaging findings, and CT course of round atelectasis — L. Azour, T. Billah, et al. (2018)
• Round atelectasis as a complication of Legionnella pneumonia — R. Kuno, D.J. Bower, et al. (1994)
• Rounded atelectasis and its association with asbestos-induced pleural disease — R.A. Mintzer, R.M. Gore, et al. (1981)
• The association of asbestos-induced pleural disease and rounded atelectasis — R.A. Mintzer, D.W. Cugell (1982)
• Rounded atelectasis complicated by obstructive pneumonia and pulmonary arterial thrombosis — C.H. Chen, L. Newman (1990)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)

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