Abstract
A 27-year-old female white-collar worker was diagnosed in 1998 with mesothelioma eight and one-half years following first exposure as a bystander to debris in a site in which asbestos-containing building materials were being dismantled and rebuilding work took place. Prodromal back pain had been present for a year and a half. She underwent extrapleural pneumectomy and received an intrapleural infusion of cisplatin post-operatively. Exposure to asbestos was verified by contemporary reports and lung biopsy, which demonstrated asbestos bodies and microscopic interstitial fibrosis -conforming evidence for asbestosis. The patient is alive and well 12 years after diagnosis and 14 years after onset of symptoms. The combination of an extremely short latency period and long survival following occupational exposure to asbestos dust is unique.
Highlights
A 27-year-old female white-collar worker was diagnosed in 1998 with mesothelioma eight and one-half years following first exposure as a bystander to debris in a site in which asbestos-containing building materials were being dismantled and rebuilding work took place
To the best of our knowledge, the seven-year latency period between first exposure and complaints, and 8.5 years (14 months lapsed between symptoms and diagnosis) to diagnosis of mesothelioma is the shortest ever reported in an adult
We note that the demonstration of several asbestos bodies in a light micrograph of lung tissue when combined with interstitial fibrosis on histology is sufficient for a diagnosis of asbestosis using standard National Institute for Occupational Health and Safety (NIOSH)/ College of American Pathology criteria [1]
Summary
To the best of our knowledge, the seven-year latency period between first exposure and complaints, and 8.5 years (14 months lapsed between symptoms and diagnosis) to diagnosis of mesothelioma is the shortest ever reported in an adult The case for this conclusion rests on both tissular and independent ascertainment of Figure 2 Asbestos bodies (l) and lung tissue with asbestos bodies (r). We note that the demonstration of several asbestos bodies in a light micrograph of lung tissue when combined with interstitial fibrosis on histology is sufficient for a diagnosis of asbestosis using standard NIOSH/ College of American Pathology criteria [1]. In comparison with mixed and sarcomatoid, the epithelial cell type described in our patient, predicts better prognosis [31,32]
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