The association of asbestos-induced pleural disease and rounded atelectasis

Our plain-English summary of The association of asbestos-induced pleural disease and rounded atelectasis, by R.A. Mintzer, D.W. Cugell (Chest, 1982).

The study

• Authors: R.A. Mintzer, D.W. Cugell
• Journal: Chest
• Published: 1982;81(4):457-60
• Cited by: 54 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. 001773).

In plain English

This article described 15 patients with rounded atelectasis at Northwestern Memorial Hospital, Chicago. Rounded atelectasis is an unusual collapse at the lung's edge. The authors called it clinically innocuous but said it can mimic a pleural or lung tumor. Over 20 months, 18 cases were identified. The 15 reported had a history of asbestos exposure; all were men aged 42 to 87. All 15 had a rounded mass, 2.0 to 7.0 cm across, at the base of the lung against the pleura. All 15 also had pleural thickening greatest near the mass, with lung between the mass and the diaphragm. Thirteen showed curved shadows toward the center of the chest, the comet tail sign. Fourteen showed an acute angle between the mass and the pleura, and 13 had a thickened fissure. In the 12 patients with older films, the mass looked nearly unchanged. Only the first patient had chest surgery to diagnose the mass. The authors concluded that X-ray features allowed diagnosis without surgery. They proposed that pleural thickening in asbestos-exposed patients makes the lung collapse and fold.

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 series: a descriptive radiologic review of patients with rounded atelectasis seen at one institution
• Who was studied: 15 men aged 42 to 87 with rounded atelectasis and a history of asbestos exposure, out of 18 cases identified over 20 months at Northwestern Memorial Hospital, Chicago
• Exposure: Asbestos exposure confirmed by the patients' history. No fiber type, job or dose is given.
• Main results:
  • All 15 patients had a rounded mass, 2.0 to 7.0 cm in diameter, in the lung base in a subpleural location
  • Curved shadows running from the mass toward the hilum (the comet tail sign) were seen in all but two patients (13 of 15)
  • An acute angle between the pleura and the mass, showing the mass was inside the lung, was present in all but one patient (14 of 15)
  • Pleural thickening greatest near the mass was seen in all 15 patients, and aerated lung lay between the mass and the diaphragm in all patients
  • A thickened fissure, described by the authors as a sign of asbestos-induced pleural disease, was seen in 13 of 15 patients
  • In the 12 of 15 patients with previous films, the appearance was nearly unchanged over time
  • In all four patients who had bronchography, the bronchi curved toward the lower pole of the mass
  • Only the first patient, studied before the authors knew of the condition, had a thoracotomy. The X-ray findings ruled out surgery in the other 14.
• The authors' conclusion: The authors concluded that the distinctive radiologic features of rounded atelectasis made surgery unnecessary for diagnosis. They proposed that the condition forms when pleural thickening in asbestos-exposed patients causes collapse just under the pleura, after which the collapsed lung curls and folds.

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: Rounded Atelectasis.

Related studies

• Rounded atelectasis and its association with asbestos-induced pleural disease — R.A. Mintzer, R.M. Gore, et al. (1981)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Rounded atelectasis and respiratory compromise secondary to pergolide use — C.I. Bloom, G.E. Wilson (2009)
• Rounded atelectasis complicated by obstructive pneumonia and pulmonary arterial thrombosis — C.H. Chen, L. Newman (1990)
• An unusual case of rounded atelectasis — G. Geremia, R.A. Mintzer (1984)
• Rounded atelectasis of the lung — G.T. Stathopoulos, M.T. Karamessini, et al. (2005)

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