The occurrence of leukemia in a patient with pulmonary asbestosis

Our plain-English summary of The occurrence of leukemia in a patient with pulmonary asbestosis, by M. Chinushi, S. Koyama, M. Takahashi, et al (Japanese Journal of Medicine, 1990).

The study

• Authors: M. Chinushi, S. Koyama, M. Takahashi, A. Shibata, I. Emura
• Journal: Japanese Journal of Medicine
• Published: 1990;29(6):607-10
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 77-year-old man, who had been a subway construction worker, was admitted to our hospital for surgical treatment of left cheek carcinoma and an examination for pancytopenia on November 17, 1986. Bone marrow aspiration revealed that 10% of the nucleated cells were blasts with morphological atypism. Bone marrow biopsy showed hypocellular marrow and a diffuse increase of argyrophil fibers with the presence of asbestos fibers was observed by microscope. A chest X-ray showed the findings of old tuberculosis and pulmonary asbestosis, and asbestos fibers were demonstrated in the broncho-pulmonary lavage fluid. He was diagnosed to have pulmonary asbestosis complicated with hypoplastic low percentage leukemia.

In plain English

This was a case report from Niigata University Hospital, Japan, about one 77-year-old man who had worked in subway construction for about 10 years. He was admitted on November 17, 1986, for surgery on a squamous cell carcinoma of the left cheek and for tests for pancytopenia (low counts of all blood cell types). In his bone marrow, 10% of nucleated cells were abnormal-looking blasts, and asbestos fibers were seen in a bone marrow biopsy under a polarized microscope. A chest X-ray showed old tuberculosis scars and shadows of pulmonary asbestosis. Asbestos bodies and fibers were found in fluid washed from his lungs. He was diagnosed with pulmonary asbestosis complicated by hypoplastic low percentage leukemia. Laboratory tests suggested immune dysfunction, but the authors called its link to the leukemia uncertain. Gamma-interferon treatment lowered marrow blasts to 2.6%, but only temporarily, and did not improve the blood counts. The article did not name a fiber type. The authors concluded that the case suggests an association between asbestos and the onset of this leukemia. It describes one patient only.

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 (single patient)
• Who was studied: One 77-year-old man, a former subway construction worker, admitted to Niigata University Hospital, Japan, on November 17, 1986
• Exposure: Work as a subway construction worker for about 10 years; the article does not name the asbestos fiber type or give exposure levels
• Main results:
  • The patient had a squamous cell carcinoma of the left cheek and was examined for pancytopenia on admission
  • In the patient's bone marrow, 10% of nucleated cells were blasts with abnormal appearance
  • Asbestos fibers were seen in the patient's bone marrow biopsy specimen under a polarized microscope
  • The chest X-ray showed scars of old tuberculosis at both lung apices and the shadow of pulmonary asbestosis. A gallium scan of the lungs was described as compatible with pulmonary asbestosis
  • Asbestos bodies and fibers were found in the patient's broncho-pulmonary lavage fluid, including inside macrophages
  • The patient was diagnosed with pulmonary asbestosis complicated with hypoplastic low percentage leukemia
  • Laboratory data suggested immune dysfunction in the patient, including a low lymphocyte response to PHA and Con A
  • After gamma-interferon treatment, the patient's marrow blasts fell to 2.6%, but this suppression was transient
• The authors' conclusion: The authors concluded that, because the leukemia was found in bone marrow that contained asbestos fibers, the case suggests an association between asbestos bodies and the onset of hypoplastic low percentage leukemia
• Limitations the authors state:
  • The authors stated that the relationship between the patient's immune dysfunction and the onset of the leukemia was uncertain

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, Carcinoma, Biopsy, Chest X-Ray.

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