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No. 73 (PP 6)
Clinicopathological analysis of asbestos-related diseases presenting asbestos bodies
in routine cytology specimens
Makihara K 1) , Kanazawa S 1) , Yoshida T 1) , Sosogi A 1) , Matsuki Y 2) , Shimajiri S 3) , Yamasaki K 4) ,
Hamada T 1)
1) Dept. Surgical Pathology and Asbestos Disease Center, Kyushu Rosai Hospital,
2) Dept. Surgical Pathology, Ootemachi Hospital,
3) Dept. Surgical Pathology, Univ. Occupational and Environmental Health, Japan
4) Dept. Respiratory Medicine, Univ. Occupational and Environmental Health , Japan
In Japan, asbestos-related diseases are predicted to increase in number within a few decades probably
due to the retarded political and legal acts for protection from the toxicity of asbestos fibers (AF).
Asbestos body (AB) is rarely encountered in the cytology smears particularly of routine specimens even
in the patient presenting asbestos-related respiratory symptoms. In our surgical pathology file, ABs
could be detected in 5 cases out of 1253 cases (0.40%), 2496 specimens in which cytological
examinations were performed in respiratory specimens. The smears included the specimens of sputum,
bronchial brushing, bronchoalveolar lavage (BAL), bronchial aspirate and tissue-imprint. All patients
were 58 to 72 (mean: 67.0) years-old Japanese male. Among the 5 cases, ABs were identified in the
smears of sputum (1/5, 20%), BAL (3/5, 60%), and tissue-imprint (1/5, 20%). A large number of ABs
were found in one case (case #1) who died due to respiratory failure by asbestosis and submit autopsy
(case report presented in the 59 th National Congress of JSLM). Briefly, he had the history of
occupational asbestos-exposure for 13 years. Over 100 asbestos bodies were counted in one H&E
sections of the lung in histological examination. Case #2 was histologically diagnosed as
pneumoconiosis after cytological identification of AB in BAL fluid. Case #3 was pulmonary nodular
amyloidosis and AB was incidentally noticed in the BAL smears. In the case #4, BAL was performed
for the examination of interstitial pneumonia associated with rheumatoid arthritis, and AB was
cytologically observed in the fluid. In another case #5, AB was found in the tissue-imprint smears of the
lung of VATS specimens resected for metastatic tumor from rectal cancer. Tissue specimens were
obtained in the cases #1 and #5 in which analyses of AB and AF will be carried out after extraction from
formalin fixed or paraffin embedded tissues.
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