1 Department of Diagnostic Pathology, Graduate School of edicine, Chiba University, Japan; 2 Department of Thoracic Surgery, Chiba Rosai Hospital, Japan; 3 Work Environment Research Group, National Institute of Occupational Safety and Health, Japan. ABSTRACT Background. ethods. Results. Conclusion. JJLC. KEY WORDS Japanese Journal of Lung Cancer
µ Figure1. Sedimentofformalin-fixedlungtissuedigested with20% sodium hypochloritesolution.iron-containingsubstanceremainsinthetubeafterthedigestion(left).ixed celuloseestermembranefilter(ilipore)throughwhich thesedimentwasfiltered(right). Japanese Journal of Lung Cancer
Figure2. Case1.Autopsyoflungcarcinomacausedbyasbestosexposure.Plaqueisobserved ontheparietalpleuraanddiaphragm (left).smalcelcarcinomaispresentintherightlung.vis ceralpleuraandinterloberpleuraarethickened.thereisalsofibrosisofthelung(right). µ φ Japanese Journal of Lung Cancer
Figure3. HistologicalfindingsofthelungparenchymaofCase1.A largenumberofasbestos bodiesareobserved(left).highermagnificationofasbestosbodies.theyarephagocytosedbyal veolarmacrophages(right). Figure4. icroscopicfindingsofasbestosbodiescolectedwithdigestiontechnique(left),and thoseobservedwithphasecontrastmicroscope(right). Japanese Journal of Lung Cancer
Figure5. Case2.A caseoflungadenocarcinomaaccompaniedbypleuralplaque.groundglassopacity wasobservedintherightupperlobeonchestct (upperleft).thereisnoapparentfibrosisinthelung (right).asbestosbodieswereobservedinthelung(lowerleft). Japanese Journal of Lung Cancer
Figure6. Case3.A caseofmalignantpleuralmesotheliomacausedbyenvironmentalexposureto asbestos.pleuralthickeningwasobservedonchestct (upperleft).thoracoscopicfindingsofthetumor (lowerleft).icroscopicfindingsofthethoracoscopicbiopsysample.thetumorcelswerecuboidalor polygonalwith moderateamountsofeosinophiliccytoplasm and round nucleicontaining asingle nucleolus.theyproliferatedinsheets,however,glandularspaceswereobserved(right). Japanese Journal of Lung Cancer
Figure7. Case4.A caseofmalignantpleuralmesotheliomatreatedwithextrapleural pneumonectomy.anabnormalshadow waspointedoutonchestroentgenogram (up perleft).thepleurawasthickenedonchestct (lowerleft).rightlungresectedwith extrapleuralpneumonectomy.tumorencapsulatedtheentirelung.thetumorin vadedintointerlobarsepta.therewasfocalinvasionintothelung(right). Table1. Summary ofdataon 14Casesofalignant Pleuralesothelioma Treated with ExtrapleuralPneu monectomy Case Subtype Sex Hyaluronicacid Asbestos Age (ng/ml) bodycounts 1 40 33,000 2 53 270,000 3 Biphasic 58 54,800 4 62 455,000 2,200 5 64 6 Biphasic 48 94,200 10,000 7 Sarcomatoid 48 380,000 8 Sarcomatoid 51 35,700 1,000 9 Sarcomatoid 59 3,200 10 66 46,800 11 61 2,660,000 14,000 12 53 123,000 13 56 290,000 0 14 44 7,500 400 Figure8. Relationshipofthenumbersofasbestosbodies oniron-stainedtissuesectionstothenumbermeasuredby atissuedigestiontechnique.thecorrelationcoeficientis significant(p<0.0001). Japanese Journal of Lung Cancer
Figure9. Pleuralplaques.Thoracoscopicfindings(left).icroscopicfindings.Theyareacelular,consistingofhyalinecolagenthathasa basket-weave patern(right). Table2. CriteriaforGradingAsbestosis 11) Severity Grade0 Grade1 Grade2 Grade3 Grade4 Extent GradeA GradeB GradeC None Fibrosisinvolveswalofatleastonerespiratory bronchiole Grade1+ involvementofalveolarductsortwoor morelayersofadjacentalveoli Grade2+ alalveolibetweenatleasttwoadjacent bronchioleshavethickened,fibroticsepta Grade3+ honeycombing Occasionalbronchioles Lessthanhalfofalbronchioles orethanhalfofalbronchioles µ µ Japanese Journal of Lung Cancer
Figure10. icroscopicfindingsofgrade1asbestosis.fibrosisisobservedinbronchiolarwal, butnofibrosisispresentindistalalveoli(left).anyasbestosbodiesarefoundinthefibrosisof bronchiolarwal(right). REFERENCES Am J Ind ed. JElectron icrosc. Ann N Y Acad Sci. Scand J Work Environ Health. Japanese Journal of Lung Cancer
Lancet. Chest. Am J Ind ed. Cancer. Hum Pathol. Arch Pathol Lab ed. Katzenstein and Askin s surgical pathology of non-neoplastic lung disease. Pathology of the lungs. Non-neoplastic disorders of the lower respiratory tract. Katzenstein and Askin s surgical pathology of non-neoplastic lung disease. Japanese Journal of Lung Cancer