Cases reported "Asbestosis"

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1/67. A retired shipyard worker with rapidly progressive pulmonary interstitial fibrosis.

    We present a case of progressive interstitial fibrosis in a retired shipyard worker who was exposed to asbestos during the postwar era of the late 1940s and 1950s, when asbestos exposures in the workplace were not regulated. Forty years later, at 63 years of age, the patient presented with restrictive lung disease. The patient was diagnosed with asbestos-related pleural disease and parenchymal asbestosis. He remained stable for the next 7 years, but then he began to manifest rapid clinical progression, which raised the possibility of an unusual variant of asbestosis, a concomitant interstitial process, or an unrelated disease. lung biopsy was not undertaken because of the patient's low pulmonary reserve and limited treatment options. An empiric trial of oral steroids was initiated, but his pulmonary status continued to deteriorate and he died of pulmonary failure at 72 years of age. Many diseases result in pulmonary interstitial fibrosis. Ideally, open lung biopsy should be performed, but this procedure inevitably causes complications in many patients with end-stage restrictive lung disease. Furthermore, while the presence of asbestos bodies in tissue sections is a sensitive and specific marker of asbestos exposure, neither this finding nor any other charge is a marker indicative of asbestosis or the severity of asbestosis. With the enactment of the Asbestos Standard in the united states, asbestos exposures have been decreasing in this country. However, industries that produce asbestos products and wastes continue to expand in developing countries. Prevention of asbestos-related lung disease should be a global endeavor, and asbestos exposures should be regulated in both developed and developing countries.
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2/67. asbestosis and small cell lung cancer in a clutch refabricator.

    OBJECTIVES: To present a case of asbestosis and small cell lung cancer caused by asbestos in a clutch refabricator. methods: Exposed surfaces of used clutches similar to those refabricated in the worker's workplace were rinsed, and the filtrate analysed by analytical transmission electron microscopy. Tissue samples were also analysed by this technique. RESULTS: Numerous chrysotile fibres of respirable dimensions and sufficient length to form ferruginous bodies (FBs) were detected from rinsed filtrates of the clutch. bronchoalveolar lavage fluid contained many FBs, characteristic of asbestos bodies. Necropsy lung tissue showed grade 4 asbestosis and a small cell carcinoma in the right pulmonary hilum. Tissue analysis by light and analytical electron microscopy showed tissue burdens of coated and uncoated asbestos fibres greatly exceeding reported environmental concentrations (3810 FBs/g dry weight and 2,080,000 structures > or = 0.5 micron/g dry weight respectively). 72% Of the cores were identified as chrysotile. CONCLUSIONS: Clutch refabrication may lead to exposure to asbestos of sufficient magnitude to cause asbestosis and lung cancer.
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3/67. Rounded atelectasis in a patient with history of asbestos exposure. A case report.

    We report a case of a 68-year-old patient with a history of chronic asbestos exposure and a lung tumour, highly suspicious for bronchial carcinoma. The patient underwent left lower lobectomy and histology showed the rare diagnosis of rounded atelectasis. Rounded atelectasis is an important differential diagnosis to bronchial carcinoma.
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4/67. Nodular pulmonary amyloidosis associated with asbestos exposure.

    A 71 year old man was admitted for the purpose of diagnosis of a right solitary pulmonary nodule. The size of the nodule was 18 x 18 mm in diameter 2 years ago, but it has become large, 25 x 25 mm in diameter. The nodule was resected by thoracotomy. Microscopically, eosinophilic amorphous, acellular substances were surrounded by inflammatory infiltrates. It stained with congo red stain and showed green birefringence with polarizing microscopy. Amyloid fibrils were observed electron microscopically. Asbestos bodies were observed in the lung parenchyma around the nodule. This case shows that a nodule in nodular pulmonary amyloidosis can grow gradually and suggests the possibility of asbestos fibers as one of the etiologic factors in nodular pulmonary amyloidosis.
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5/67. asbestosis in malaysia: report on first two cases.

    The first two cases of asbestosis in malaysia are reported. Both had considerable occupational exposure to asbestos dust in the past, with a long latency period exceeding 30 years. One case presented with distinctive clinical and radiological features, while the other case was only confirmed by histological diagnosis. The usefulness of modern investigation techniques such as CT scan in the diagnosis of asbestosis is also illustrated.
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ranking = 54.298617444746
keywords = occupational exposure, exposure
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6/67. Nodular thickening of interlobar fissures: an early manifestation of malignant mesothelioma: a case report.

    Two men with occupational exposure to asbestos were admitted to our hospital with minute pleural changes on their chest CT image. Conventional computed tomography (CT) scans of the chest showed slightly thickened interlobar fissures and a small amount of pleural effusion. In addition, high-resolution CT showed small nodular opacities on interlobar fissures. There were no intrapulmonary mass shadows, pleural plaques or other extrapulmonary mass shadows. These roentgenographical findings were very similar to each other. Hyarulonic acid values obtained from their pleural fluid were extremely high. Finally, we diagnosed them as having malignant mesothelioma using an immunocytochemical technique and electronmicroscopy. We conclude that HRCT is helpful in the diagnosis of malignant mesothelioma, particularly in its early manifestation such as nodular opacities of interlobar fissures.
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ranking = 54.298617444746
keywords = occupational exposure, exposure
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7/67. Atypical carcinoid presenting as mesothelioma.

    Two patients presented with pleuritic pain and dyspnoe together with pleural thickening on the X-ray of the chest. In both a history of exposure to asbestos existed suggesting mesothelioma. A definite diagnosis could not be made and therefore therapy was symptomatic. autopsy revealed the unexpected diagnosis of atypical carcinoid of the lung. In one case, pleural spread of tumor was seen while in the other an extensive fibrotic pleural reaction existed. To our knowledge these cases represent the first examples of atypical carcinoid causing pseudomesothelioma.
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8/67. Fatal asbestosis 50 years after brief high intensity exposure in a vermiculite expansion plant.

    The authors report the case of a 65-year-old accountant whose only asbestos exposure was during a summer job 50 years earlier in a california vermiculite expansion plant. Vermiculite is a silicate material that is useful in building and agriculture as a filler and insulating agent. He developed extensive fibrocalcific pleural plaques and end-stage pulmonary fibrosis, with rapidly progressive respiratory failure. Careful occupational and environmental history revealed no other source of asbestos exposure, and the initial clinical diagnosis was idiopathic pulmonary fibrosis; open lung biopsy shortly before his death confirmed asbestosis. Electron microscopic lung fiber burden analysis revealed over 8,000,000 asbestos fibers per gram dry lung, 68% of which were tremolite asbestos. Additional asbestiform fibers of composition not matching any of the standard asbestos varieties were also present at over 5,000,000 fibers per gram dry lung. Comparison analysis of a sample of Libby, montana, vermiculite showed a similar mix of asbestiform fibers including tremolite asbestos. This case analysis raises several concerns: risks of vermiculite induced disease among former workers of the more than 200 expansion plants throughout the united states; health effects of brief but very high-intensity exposures to asbestos; and possible health effects in end-users of consumer products containing vermiculite.
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ranking = 1.75
keywords = exposure
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9/67. Papillary mesothelioma of the peritoneum in the absence of asbestos exposure.

    BACKGROUND: Malignant mesothelioma of the peritoneum is a very rare neoplasm, commonly associated with asbestos exposure and often rapidly fatal. Well Differentiated Papillary mesothelioma of the peritoneum (WDPMP) is regarded as a less aggressive variety of the tumor. Progressive ascites is often the only clinical manifestation of the disease and differentiation of WDPMP from benign mesothelial hyperplasia or adenocarcinoma is difficult. patients AND methods: Here we report the case of a 45-year-old patient who presented with ascites but without evidence of portal hypertension, liver disease or abdominal malignancy. On diagnostic laparoscopy small tumor nodules were found to cover the parietal peritoneum and the greater omentum and histopathologically corresponded to papillary mesothelial hyperplasia with minimal nuclear atypia. Histochemically biopsies were positive for Calretinin, Cytokeratins and Epithelial Membrane Antigen (EMA). Based on these findings the diagnosis of WDPMP was made and the patient was closely followed without primary cytostatic therapy. CONCLUSIONS: Progressive ascites was the only clinical symptom in this patient, while liver disease, portal hypertension and gastrointestinal malignancies were ruled out by clinical, laboratory and imaging techniques. Laparoscopic biopsy revealed WDPMP to be the underlying disease. Immunocytochemistry is required to establish the diagnosis of this rare malignant disorder which is even more uncommon in the absence of a history of asbestos exposure. Due to the indolent course of WDPMP therapy should only be initiated when signs of rapid tumor progression become apparent.
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10/67. Environmental sample correlation with clinical and historical data in a friction product exposure.

    Asbestos has been widely used in the past as a component in friction products. A unique setting of dust exposure to such products occurs when individuals are involved with refabrication of the worn components. It is of interest whether asbestos fibers are released from friction materials in the use phase and the postlife phase or if the mineral fibers are converted to a nonasbestos form. In the present study, an individual whose primary work activity had centered on clutch refabrication was evaluated for possible dust-related diseases. Tissue analysis revealed the presence of large numbers of asbestos fibers as well as ferruginous bodies. These particulates were characterized as to composition as well as dimensions. Clutches of the type typically used by this individual were obtained and material was rinsed from their surface for comparative purposes. Materials that were freed from the surface and reviewed by analytical transmission electron microscopy were clearly identifiable as chrysotile asbestos. The composition of the clutch material was compared with the components found in the patient's lung tissue. The conclusion from this comparison was that individuals exposed to friction materials under similar circumstances should use appropriate caution. Appreciable exposure to asbestos can occur and this exposure can be sufficiently high to result in disease.
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ranking = 1.75
keywords = exposure
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