Benign asbestos pleurisy: Clinical findings

28

d e n s i t y (number of charges per gram of protein). Double R e f r a c t i l e Crystals(DRC) in the Lung T i s s u e o f Lung C a n c e r P a t i e n t s Exp o s e d to Asbestos. 1 1 2 M i u r a , ~., K i m u l a , Y'I Tachi , H., 1 Nakayama-, M., T a k a y a m a , S. Makiguchi , K. i. Y o k o s u k a Kyosai Hospital, Kanagawa, Japan. 2. Institute of Basic Medical Sciences, U n i v e r s i t y of Tsukuba, Ibaraki, Japan. The difference in t u m o r i g e n e s i s among various types of asbestos has b e e n reported in m a n y papers. Lung C a n c e r and/or pleural m e s o t h e l i o m a o c c u r frequently in w o r k e r s e x p o s e d to crocidolite. We disclosed that many DRC were found m o r e among crocidolite than chrysotile. In this paper, i n t r a p u l m o n a r y DRC of lung cancer p a t i e n t s w e r e c o m p a r e d to that of noncancer groups. Lung tissues w e r e e x a m i n e d under polarized m i c r o s c o p e s and a score of DRC was c a l c u l a t e d with the p e r c e n t a g e of the field (200x v i e w field) containing DRC. Mean DRC score in a g e - m a t c h e d following groups; A: a s b e s t o s - e x p o s e d w o r k e r s ( 3 7 p t s ) . . 7 9 % B: male office clerks (37 pts)..38% C: house wives (37 pts)..32% (P<0.001:A and B, A and C) DRC score in age- and se.~natched 84 pairs of lung cancer group and non-lung cancer group; DRC score 0-14 15-29 30-44 45-59 60-74 75-89 90-100% A:Lung caner I 7 9 18 25 15 9 2 B:Non-lung caner 9 17 16 17 14 9 C:Percentage of A 10 29 36 51 64 63 82% (positive c o r r e l a t i o n b e t w e e n DRC score and C, P<0.01) An elemental analysis of DRC w i t h an x-ray m i c r o a n a l y s e r r e v e a l e d that DRC c o n t a i n e d Si and A1. These data showed that DRC were found more frequently in p a t i e n t s e x p o s e d to asbestos and the d e p o s i t i o n of DRC in lung tissue had a p o s i t i v e c o r r e l a t i o n w i t h the occurrence of lung cancer. DRC have an important role on p u l m o n a r y c a r c i n o g e n e s i s rather than asbestos fibers. Benign A s b e s t o s Pleurisy: C l i n i c n l Findinzs. Hillerdal, G., Ozesmi, M. D e p a r t m e n t of Lung Medicine, U n i v e r s i t y Hospital, Uppsala, Sweden. Benign asbestos p l e u r i s y is a fairly common occurrence w h i c h is often m i s d i a g nosed. We have r e v i e w e d our e x p e r i e n c e of 55 cases seen over the last 15 years. The c r i t e r i a have been: e x p o s u r e to asbestos and exclusion of other diseases, notably TB and malignancy. The p a t i e n t s were seen among the more than 150G persons

with a s b e s t o s - r e l a t e d p l e u r a l a n d p a r e n c h y m a l changes who are regularly followed. There was only one woman. Mean age was 57 years, with e x t r e m e s of 32 and 76 years. Smokers or exsmokers were 52. Mean latency time from first exposure was 32 years (2-54). In 23 cases, aspiration of fluid and a b l i n d p l e u r a l biopsy was made. Four were finally decorticated, one because of false c y t o l o g i c a l d i a g n o s i s of m a l i g n a n c y (all others were negative). E r y t h r o c y t e s e d i m e n t a t i o n rate was more than 20 in 33 cases. In blood, slight e o s i n o p h i l i a was seen in 16 cases and m a r k e d e o s i n o p h i l i a was found in two exudates. The disease was usually d e v o i d of symptoms, and it tended to linger on for months, and there were o f t e n recurrence on the same or the other side. Sex C h a r a c t e r i s t i c s in R e s e c t e d Lung Cancers. Bringel, C . . H u d d i n g e U n i v e r s i t y Hospital, Stockholm, Sweden. During 1981-84 surgery was p e r f o r m e d in 35/ 151 w o m e n (23%) and 70/473 men (15%) with b r o n chial malignancies. Age range for w o m e n was 34-76 years, for m e n 40-79 years, m e d i a n age was 64 and 63 respectively. Six w o m e n were u n d e r 45 years, only one man. Women did smoke less, 76% were smokers/exsmokers, 98.5% of the men. H i s t o l o g i c a l l y there was a slight p r e d o m i nance of a d e n o c a r c i n o m a s over squamous cell carcinomas in w o m e n 14/11, while in men the opposite condition was p r e s e n t 29/25. Among female a d e n o c a r c i n o m a s 4/14 c o n s i s t e d of b r o n c h o a l v e o l a r cancer c o m p a r e d to 2/26 in men. Carcinoid tumours were d i a g n o s e d in six w o m e n and two men. T u m o u r localisation was m o s t frequent in the upper lobes in both sexes. P o s t s u r g i c a l l y 27/35 w o m e n (77%) w e r e c l a s s i f i e d as stage I, 20 of these had a tumour size less than 30 m m - T In 12 female cases the tumour had been i" r o e n t g e n o l o g i c a l l y o b s e r v e d b e t w e e n 1½ and six~ years p r i o r to surgery. Delays longer than a few months were only o c c a s i o n a l l y seen in men. Male surgical stage I was only 70% but only 15 had T~ tumours. The g r e a t e r number of tumours exceedin~ 30 m m could p a r t l y explain the greater need for p u l m e c t o m y in men, 15, c o m p a r e d to 5 in women. Prevalence o f S p u t u m C y t o l o g i c a l A b n o r m a l i t i e s in A h m i n i u m P o t r o o m Workers. Enarson, D.A., Embree, V., LeRiche, J., Nelems, B. D e p a r t m e n t of Medicine, UBC, V a n c o u v e r General Hospital, Vancouver, B.C. As p a r t of a lung cancer screening p r o g r a m in m i n i n g and related o c c u p a t i o n s in BC, 2467 individuals 40+ years of age have been studied (82% of the available workforce). This included groups with and w i t h o u t known o c c u p a t i o n a l exposure to substances causing lung cancer. Among the former were 245 individuals w i t h 5+ years e x p e r i e n c e in a l u m i n u m potrooms. Study procedures included a questionnaire,

sputum