1/18. Accelerated silicosis with mixed-dust pneumoconiosis in a hard-metal grinder.We describe a fatal case of accelerated silicosis with a component of mixed-dust pneumoconiosis in a young hard-metal grinder that we believe is the first case of its kind in israel and one of the rare cases reported worldwide. The patient's diagnosis was based on typical features: restrictive lung function, abnormal chest roentgenogram suggesting lung fibrosis, a history of exposure to silica and hard metals, bronchoalveolar lavage (BAL) fluid findings, and mineralogical studies. BAL cells showed an abundance of giant multinucleated macrophages. The CD4/CD8 ratio of T lymphocytes was 1.1, with a high percentage of CD8 and CD8/38 positive cells (37% suppressor/cytotoxic and 12% cytotoxic T lymphocytes, respectively). mRNA transcripts isolated from BAL cells were positive for interleukin-1 (IL-1) and transforming growth factor (TGF) Il-5, IL-2, and IL-10 but not for IL-6, IL-4, and interferon. Polarizing light microscopic studies of BAL and induced sputum cells showed polarizing particles, which are typical for silica. Mineralogical studies of electron microscopy performed on BAL fluid and on dust collected at the patient's workstation revealed silica particles as well as aluminum-titanium and other particles. The latter might have contributed to the patient's lung disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/18. Injuries to avian researchers at Palmer Station, Antarctica from penguins, giant petrels, and skuas.This paper describes 5 cases of injury to seabird researchers between 1996 and 1999 at Palmer Station, Antarctica. The injuries were inflicted by 3 seabird species: the Adelie penguin (Pygoscelis adeliae); the southern giant petrel (Macronectes giganteus); and the brown skua (Catharacta lonnbergi). All injured parties were biologic researchers with previous field experience working under National science Foundation research grants; all sought medical evaluation and treatment voluntarily. The nature and frequency of such injuries seems not to have been greatly reported in the medical literature. Although these cases were largely soft tissue injuries that healed without serious complications, the possibility of exotic infections is considered. We have dubbed this constellation of injuries AVES (Antarctic Vogel [German for bird] Encounter syndrome).- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
3/18. Giant cell pneumonitis induced by cobalt.cobalt alone and in combination with tungsten carbide known as hard metal is capable of causing lung damage. This may vary from development of pulmonary oedema to asthma and fibrosing alveolitis. We report a case of giant cell interstitial pneumonitis caused by exposure to cobalt dust which was not identified as the etiological agent initially and hence led to progression of the disease. The patient subsequently improved following cessation of exposure and treatment with oral corticosteriods, thereby stressing the importance of occupational history in all cases of interstitial pulmonary fibrosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/18. Chronic hypersensitivity pneumonitis induced by Shiitake mushroom spores associated with lung cancer.A 61-year-old man was admitted to our hospital with a 6-month history of productive cough. He, along with his wife, had been involved with Shiitake mushroom cultures for a period of 12 years. On admission, chest radiography showed bilateral fine-nodular shadow and CT scans showed reticulonodular opacities and a ground-glass appearance predominantly in the subpleural area in both lungs, and a mass in the left S6. Resected pathological specimens obtained by left lower lobectomy revealed lung adenosquamous carcinoma (stage IB), interstitial changes accompanied with lymphocyte proliferation and fibrosis, and granuloma with giant cells. serum precipitins for Shiitake mushroom antigens were positive. The productive cough improved after the hospital admission and occurred again when he returned to work with the Shiitake mushroom production. Therefore, chronic hypersensitivity pneumonitis (HP) caused by Shiitake mushroom spores was diagnosed. Moreover, his wife was found to have HP caused by mushrooms at this time. There are only two previous reports of chronic HP caused by Shiitake mushroom in japan, and this is the first case of chronic HP associated with lung cancer.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/18. Clinicopathological features of pure mica pneumoconiosis associated with Sjogren syndrome.BACKGROUND: There are few reports on the clinical, radiologic, and pathologic features of pure mica pneumoconiosis. methods: A case of definite pure mica pneumoconiosis in a rubber factory worker is reported with the clinicopathological findings. RESULTS: Chest HRCT demonstrated subpleural and peribronchovascular interstitial thickening. The characteristic histologic features were pulmonary fibrosis accompanied by prominent histiocytic granulomas containing giant cells. CONCLUSIONS: Pure mica pneumoconiosis can be identified by specific radiologic and pathologic findings.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/18. "giant axonal neuropathy" caused by industrial chemicals: neurofilamentous axonal masses in man.Symmetrical polyneuropathy developed in two patients after they had been in contact with acrylamide and methyl n-butyl ketone, respectively. In sural nerve biopsy material from both patients, electron microscopy showed frequent focal axonal swellings containing masses of neurofilaments. Some axons undergoing axonal degeneration also were seen. These morphologic features are identical to those produced in experimental animals after exposure to these chemicals and are similar to those found in n-hexane neuropathy and in the three reported cases of giant axonal neuropathy. sural nerve biopsy is an important diagnostic test in identifying cases of peripheral neuropathy caused by these chemicals.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/18. "Blue bodies" in a case of cryptogenic fibrosing alveolitis (desquamative type) an ultra-structural study.A patient with cryptogenic fibrosing alveolitis, with both mural and desquamative features, had two lung biopsies at the times of coronary artery surgery. These lung specimens were studied, using light and electron microscopy, with immunofluorescence techniques and electron microanalysis. In addition to the typical changes of cryptogenic fibrosing alveolitis previously reported, we found "blue-staining bodies" within alveolar macrophages and giant cells. These bodies were 15--25 micrometer in diameter with an iron rich outer rim and core of connective tissue mucin--possibly chondroitin sulphate or dermatan sulphate. It seems unlikely that these "blue bodies" were due to fibreglass dust to which the patients had had a trivial exposure, but their exact nature and significance remains unclear.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/18. Giant-cell interstitial pneumonia and hard-metal pneumoconiosis. A clinicopathologic study of four cases and review of the literature.We report four cases of giant-cell interstitial pneumonia that occurred in association with exposure to hard metals. All patients presented with chronic interstitial lung disease and had open-lung biopsies that revealed marked interstitial fibrosis, cellular interstitial infiltrates, and prominent intraalveolar macrophages as well as giant cells displaying cellular cannibalism. We also review the literature to determine the sensitivity and specificity of giant-cell interstitial pneumonia for hard-metal pneumoconiosis. Although hard-metal pneumoconiosis may take the form of usual interstitial pneumonia, desquamative interstitial pneumonia, and giant-cell interstitial pneumonia, the finding of giant-cell interstitial pneumonia is almost pathognomonic of hard-metal disease and should provoke an investigation of occupational exposure.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
9/18. Giant cell interstitial pneumonia in a hard-metal worker. Cytologic, histologic and analytical electron microscopic investigation.A case of biopsy-proven giant cell interstitial pneumonia in a patient with occupational exposure to hard-metal dust is reported. Bronchial washings performed several days prior to open-lung biopsy yielded an almost exclusive population of nonpigmented alveolar macrophages and pleomorphic, phagocytic multinucleated giant cells. Microorganisms, viral inclusions in the giant cells, epithelioid histiocytes and well-formed granulomas were not seen. This cytologic picture strongly suggests the presence of giant cell interstitial pneumonia in a patient with restrictive lung disease, particularly when exposure to hard-metal dust is known or suspected. A specific diagnosis early in the course of the disease may facilitate removal of the individual from the workplace and forestall the development of end-stage interstitial fibrosis. Additionally, the working environment may be modified to minimize inhalational exposure. Recognition of this entity by the cytopathologist may direct diagnostic efforts toward accurate histologic evaluation and the identification of particulates by microprobe analysis of either cellular or biopsy material.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/18. Extrinsic allergic alveolitis caused by a cold water humidifier.Three workers developed classical extrinsic allergic alveolitis while working in a printing works that had a contaminated cold water humidifier. All had nodular shadows on their chest radiographs, reduced gas transfer measurements, and lung biopsy specimens that showed an alveolitis with giant cells and cholesterol clefts. In two subjects bronchoalveolar lavage was performed and the lavage fluid contained more than 70% lymphocytes in each case. bronchial provocation tests with the humidifier antigen in these two workers reproduced their symptoms. Unlike previously reported cases, where exposure was to humidifiers working at generally higher temperatures, challenge with thermophilic actinomycetes in our two patients produced no reaction. Tests for precipitins to the humidifier antigen gave strongly positive reactions in the three workers but no single organism isolated from the humidifier produced a significantly positive reaction.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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