MESOTHELIOMA ASSOCIATED WITH ASBESTOSIS
T peritoneum and pleura with asbestosis
has been recognized recently. The number of
cases reported to date has been small and the
causal relationship requires additional confirmation.
Recent reports from South Africa,l‘, 14
Great Britain22 3959 7911 and this countryst 9
have incriminated pulmonary asbestosis in a
causal role with respect to pleural and peritoneal
mesothelioma. Wagner et al.14 described
33 cases of pleural mesothelioma,
which they related to asbestos exposure.
Thornson12 associated 7 cases of mesothelioma,
4 in the pleura and 3 in the peritoneum with
pulmonary asbestosis.
Selikoff, Churg and Hammondg described
4 cases of pleural mesothelioma and 6 of
peritoneal mesothelioma in 307 consecutive
deaths among asbestos insulation workers from
January 1943 through August 1964. The same
authors found asbestos bodies in 12 of the 45
inesotheliomas in the Armed Forces Institute
of Pathology material upon review. These investigators
emphasized the importance of a
diligent search for asbestos bodies in the lungs
of autopsied patients who have mesothelioma.
In a study6 covering 1940 through 1965 autopsies
were performed on 54 patients with
pathologic evidence of asbestosis at the Lancaster
General Hospital; 22 patients had
bronchogenic carcinoma; 3 individuals had
From the Departments of Medicine and Pathology,
Lancaster General Hospital, Lancastcr, Pa.
Receircd for publication August 27, 1969.
mesotheliomas of the peritoneum and one had
associated mesothelioma of the pleura.
The 3 patients with mesothelioma had been
admitted to the medical or surgical service of
the Lancaster General Hospital. Two of the 3
individuals had been employed in the same
plant involved in the textile phase of the
asbestos industry. We do not know the manner
of exposure of the third patient.
CASE REPORTS
Case I (S.B., D-65820). A 53-year-old male
factory worker was admitted to the hospital in
October 1964 with a chief complaint of abdominal
distress and distention of 2-week duration.
He gave a history of smoking a pack
of cigarettes daily for most of his adult life.
On physical examination, the patient appeared
to be chronically ill. Rales and coarse
rhonchi were heard throughout both lung
fields. The abdomen was distended; shifting
dullness was present in the flanks and tympanic
percussion was elicited over the anterior
portion of the abdomen. There were no
palpable organs or masses in the abdomen.
The bowel sounds were normal.
The blood count, urinalysis and blood indices
were within normal limits. An x-ray of
the colon was not remarkable except for evidence
of ascites. Infiltration of the bases of
both lungs, blunting of the costophrenic angles
and adhesions to the diaphragm were
present on x-ray study. Calcification over the
right diaphragmatic and mediastinal areas was
present. The x-ray findings were interpreted
as compatible with the fibrosis associated with
asbestosis. A history of exposure to asbestos
إرسال تعليق