Document wqeap3VGakwraxpnq9jer5XZd

V. \1 *>-*4-328 Sot. 20, 1944 (Received) Herbert C. Scoble Ige 42 P.M. Hra. 5 Received fron Dr. R. J. Rltterhoff of Hamilton County Tuberculosis Sanatorium of Cincinnati, Ohio, seven eeatlone of lung and one each of heart, spleen, liver and with a green connective tieeue mixture plus eeven unetained aeotiona. On Deoember 26 he aent a generoua gross sample of lung and hilar lymph node tieeue for chemical, petrographlo and apectrograpblc analysis. Ria diagnosis was asbestosis sal aarooid. QOCCOUPATIIOONN'AL HRIIS3TTO0RY1 - tenplovyed for 25 yvearas Iin thae dpIipme daenparLt. ment of the Phillip Carey Coapany of Cincinnati, Ohio; for the last 9 or 6 years as foreman. Product, "Air Cell Paper Asbestos Pipes" - using staroh, sodium silicate glue and asbestoa. Prooese, wet exoeptfor cutting and squaring ends of finished material. Sou duet la spite ' of exhaust. The hazard in the plant is probably not great as the labor turn-over Is low and many employees have worked from 6 to 30 years.' Ho record that fiooble had been exposed to beryllium or fluoresoent aubetanoes here or In any other employment. for Cross Description: see appended protocol. Hole that tha size-, 'and frequency of the large flbroue grey pigmented fool seems more pro minent on gross than on miorosooplo examination. The lesions as la oases of uncomplicated asbestosis, ooaur toward the centre of lobules which are separated from one another by thlok non-pigmented septa. How ever, there seems to be more flbroue replacement and leas emphyseam accompanying the grey pigment than in most cases of unooaplloated asbestosis. The minute oolorleea sarcoid nodules are readily discernible throughout the parenchyma and in places some projeot above the surfeoe of the thickened pleura. The hilar lymph nodes are larger than la simple asbestosis. UARX -- Home Interstitial fibrosis with a snail ssroold nodule sur- roundLed by ooonneotlve tissue in a papillary busole. b LOHCO - The diagnosis of asbestosis and earcoid is confirmed. Tha asbestosis seems to be mederate in extent but old while the ssroold consists largely of young proliferative nodules without oonglameratlon or hyaline changes. Both inclusion bodies of aarooid and asbestosis bodies are present. Zndloatlva of asbestosis are the thick fibrous pleura and Inter lobular aapta and the elem^ted stringy areas of fibrosis extending along trunks often more or lees perpendioular to the pleura. Tbs latter lesions are eoapossd of fairly heavy discrete collagenous fibres and ' oontala considerable asounte of duet and some asbestosis bodies. These masses have oontreoted to produce more or leae stellate borders with radical strands extending Into the surrounding alveolar walls. 'Extending Into these maeefs arm terminal hronohUss whose lumlna are largely dosed. Of course, the aseoolated branches of tha pulmonary artery also eater the ass but there has been so mnoh ocntrsotlon of the soar tlsaaa that the PLAINTlFPSipl IDITvW! |j <su- 9-44-326 Page Two characterletlo peribronchiolar relationships are no longer recognisable. i The sarcoid leslonB are small flbroua or more rarely oellular nodulea containing one or more giant oells. As In uncomplicated oasss they occur In Interstitial tissue, the shenths of bronchi and blood Teasels and the alveolar and Interlobular septa. In addition, nodules are found at the margins of areas of the dust fibrosis.Where the duet f reaction Is heaviest, especially beneath the pleura, the nodules are definitely within the aabeetotlc fibrous tleeue. The giant and eplthelold cells of the earcold show no evidence of degeneration as evidenced by fat stalnable with Soharlach R. They are surrounded by a delicate reticulum (black, with Foot-Blelschowekl) and 1 at the periphery of the nodule are concentric bands of heavy non-hyallne | .collagen. The elastlo tissue Is probably pushed aelde In the formation ; of noaulea. Indus Ion bodies In the giant oells of tha sarcoid granulomas are fairly numerous; thoae tnat occur are largely of the round or oval < orenated conchoids! type. These stain black with hematoxylin, red with the add fushsln of Van Bleson-Velgert Instead of blaak like elaetla tissue. Von Kossa's oalolum ataln Is negative. Thar give a strong frussjon Blue reaction for Iron- On teetlng other caars of earoola It It ound that in them also the lnolualona contain Iron and not elaatlo or o4lclum. Occasionally typical aabeatoale bodies are found within the earoold noduleo. -e The/aebeatoele bodies lr. the pneumoconlotlo tissue reveal marked and unusual modification In ferrooyanlde preparations. Many of the h bodies/have one or several very large swellings either terminal or In ^ the middle of the fibre. Blrarre forma develop about the partially . aepidraxed bundles of asbeetos. The oonchold&l rounded masses are muoh Boris abundat here than within the earcold nodules. Muoh of the grannular duet in the lesions la apparently iron. The blood veaesls and bronahlal tree show nothing unusual exoept for the earcold nodules In their sheaths. There Is no evidence of Inflammatory reaoilon or pneumonic exudate. IYK?H FQDgB - Largely replaced hy earcold nodules varying from oellular to fibrous in character. Ho necrosis. All show giant oella vacuolated but no Inclusion bodies. Varying numbers of lymphooyte# In most of the lesions. 8PLEQ1 - A few small earcold nodules with giant oella but no lnclusloi bodies. LIVCR - Same as spleen. nPHETB - 0 earoold; email fool of echlerosle with arteriolar sclero sis. P"44^325 S ') Ash ,70jf of Dry Tissue (Dry Tissue approximately li.ljC of Mclat Tissue) ASH Elements Frost Cheaicul Speotrographlo PbLess than O.l&jf La *4 < * K .... 36.7 .. ------- 75 ----- 100