An autopsy case of diffuse pleural thickening presented respiratory impairment and benign asbestos pleurisy
Wednesday, June 4th, 2008.
Nihon Kokyūki Gakkai Zasshi. 2008 May;46(5):368-73. [Link]
Morokawa N, Takayanagi N, Ubukata M, Kurashima K, Yoned K, Tsuchiy N, Miyahara Y, Yamaguchi S, Tokunaga D, Saito H, Yanagisawa T, Sugita Y, Kawabata Y.
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center.
Abstract
A 51-year-old man presented with back pain in 1997. He had a 30-year-history of occupational asbestos exposure. His chest CT showed bilateral pleural thickening and pleural effusion. The pleural effusion of the right thorax exhibited both elevated level of adenosine deaminase and increased numbers of lymphocytes. Antituberculous chemotherapy had no effect on the exudates. Progressive bilateral pleural thickening were found on chest CT, and pulmonary function tests showed severe restrictive ventilatory impairments since 1998. Thoracoscopic pleural biopsy was conducted in 2001 to exclude pleural malignant mesothelioma. No malignancy was found in pleural samples. After 3-year observation and excluding other causes, he was given a diagnosis of benign asbestos pleurisy. In 2005, fibrotic changes were found in both lower lung fields in chest CT. He suffered from respiratory failure with carbon dioxide retention, and died in 2006. The autopsy disclosed asbestos-related lung diseases. We suspected that diffuse pleural thickening could be a major cause of fatal respiratory impairment in this case.
Glossary
- lymphocytes
- a type of white blood cell that helps the body fight infection.
- diagnosis
- identifying a disease by its signs or symptoms, and by using imaging procedures and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.
- chemotherapy
- (key-mo-THER-uh-pee) treatment with drugs to destroy cancer cells. Chemotherapy is often used with surgery or radiation to treat cancer when the cancer has spread, when it has come back (recurred), or when there is a strong chance that it could recur.
- biopsy
- (buy-op-see) the removal of a sample of tissue to see whether cancer cells are present. There are several kinds of biopsies. In some, a very thin needle is used to draw fluid and cells from a lump. In a core biopsy, a larger needle is used to remove more tissue.
- bilateral
- (bi-lat-er-ul) on both sides of the body; for example, bilateral breast cancer is cancer in both breasts.
- benign
- (be-nine) not cancer; not malignant.
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- pleural effusion
- an abnormal accumulation of fluid, usually caused by trauma or disease, in the pleural space.
