ABSTRACT
The histologic types of lung cancer in 855 patients (747 men and 107 women) from three hospitals and one international study of insulation workers were evaluated. Of these, 196 cases had asbestos exposure. About one half of the cases were diagnosed from surgical slides and one half from autopsy slides. Squamous cell carcinoma constituted the largest percentage of tumor types and was found with the same frequency in exposed and nonexposed groups. Small cell carcinoma was found in 25% of the exposed and in 15% of the nonexposed patients. Upper lung sites were involved in about two thirds of the cases with asbestos exposure and lower lobes in the other one third. There was little difference in histologic type in cases regardless of whether upper or lower lobes were involved. Cigarette smokers who smoked until their cancer diagnosis showed no difference in histologic type by amount smoked, and slight but not statistically significant differences from ex-cigarette smokers.
Subject(s)
Asbestos/adverse effects , Lung Neoplasms/classification , Adenocarcinoma/etiology , Adult , Aged , Carcinoma, Small Cell/etiology , Carcinoma, Squamous Cell/etiology , Female , Humans , Lung Neoplasms/etiology , Male , Middle Aged , SmokingABSTRACT
Seventy-five cases of diffuse pleural and/or peritoneal malignant mesothelioma (73 of body cavity fluids and 2 of fine needle aspirates) were studied by cytologic methods. Of the three major histologic varieties of mesothelioma (epithelioid, fibrous and mixed, or biphasic), the epithelioid and biphasic types were associated with four cytomorphologic features useful in the diagnostic evaluation: (1) the presence of abnormal cells, apparently mesothelial, (2) nuclei with subtle malignant features, (3) the presence of cells showing transitional forms from normal to abnormal in the same sample and (4) the presence of large tissue fragments. The fibrous mesotheliomas presented cytologically as sarcomatous neoplasms. Three histochemical reactions were found to be valuable adjuncts to diagnosis in the differentiation of the primary malignancies of the serous membranes from metastatic cancers. These stains were the periodic acid-Schiff, with and without diastase digestion, the Alcian blue, with and without hyaluronidase digestion, and the Van Gieson. The histochemistry was diagnostically useful in 42% of the cases in which the cytomorphologic impression was uncertain or equivocal; it served as an added confirmatory finding in 64% of the cytologically diagnosable mesotheliomas.
Subject(s)
Carmine , Mesothelioma/pathology , Aged , Alcian Blue , Amylases , Cell Nucleus/pathology , Coloring Agents , Cytodiagnosis , Female , Histocytochemistry , Humans , Hyaluronoglucosaminidase , Male , Middle Aged , Periodic Acid-Schiff Reaction , Peritoneal Neoplasms/pathology , Pleural Neoplasms/pathology , Staining and LabelingABSTRACT
This study was designed to test the hypothesis that subjects with many asbestos bodies in their lungs at autopsy would also have asbestos bodies in various other organs. The subjects included 19 cases with diagnosis of asbestosis at death (two of these had mesothelioma, five had lung cancer) and 18 with pleural plaques but not asbestosis. Occupational histories were obtained from relatives. In subjects occupationally exposed to asbestos, large numbers of asbestos bodies were found in the lungs, and in most of these, asbestos bodies were found in many of the other organs examined. In the 18 cases with only pleural plaques found at autopsy, considerably fewer asbestos bodies were found in the lungs. The number of other organs with one or more asbestos bodies ranged from 32 percent to 62 percent of the sites examined. The findings seem to confirm the hypothesis of the study.
