Document x5YE1E9e4rvy0pJw20Ozd35qy

F-44-926 *ovr -20, 1944 (Reaelved) Herbert C. Bcable Aga 42 . Hro. a Received froa Sr. R. J. Rltterhoff of Haalltan County Tnheru.Teai, Sanatorium of Cincinnati, Ohio, seven sections of' lung and. oh* pr* Heart, spleen. liver and with a green connectlx# tissue mixture slai seven unstained, sections. On December 26 ha sent agenaroua gross ' sample of lung and hilar lymph node tissue forchstalcal. petrographlo- and. epsatrograpixic analysis. His diagnosis was ashestoals aaroold. I qCCCPATICKkL HI8T0RT - fealoyad for 25 years In tha pipe depart* sent of the Phillip Carey Coepany of Cincinnati. Ohio; for the last 3 or 6 years aa foreman. Product, 9Air Cell Paper Asbestos Plpee" - using search, aodlua silicate glue and asbestos. Prooaea, vet exceptfor cutting and squaring ends of finished material. Soea duat la spite of exhaust. The hazard in the plant la probably not great as the labor turn-over la low arid many anployeee have worked from 0 to 30 yoan So record that Soohio had been exposed to beryllium or fluorescent substances here or in any other employment. Per Cross Description: see appended protocol. Bote that the slxe-1 and frequency of the largo fibrous grey plgaented fool seeas mere pro-- mlnent on gross than on moroeooplo examination. The leelonm as la cases of unoonpllaated asbestosis. ooaur toward the asntre of lobules which ere separated froa one another by thick. non-pignentsd septa. How ever* there seema to be sore fibrous replacement and less emphysema accompanying tha grey pigment than in most oases of uncompUaated asbsteels. The mlzxmta oolorlesa aaroold nodulesarw readily disoerolh throughout the parenchyma end in places same project above the surface of the thickened pleura. The hilar lymph nodes are larger than lm alople asheatosla. gswraeg . EA - Boms Interstitial fibrosis with, a small aaroold nodula aur rounded by oonneotive tlaaua in a papillary auaole. LPKOfl -- The diagnosis of asbestosl* and sarcoid la confirmed. The aabeatoaia aesas to be mederete in extent but old while the aremidt* consistslargsly of young proliferative nodules without oocgloaeratiom Or hyaline changes. Both. Inclusion hodlee of aaroold and aeheatoala bodies are present. -` Indiostive of aebeetoole ere the thlok fibrous pleura and Inter-- lobular septa and the eloagplted stringy 'areas of flbroala extending along trunks often more or less perpen&laular to the pleura.^ The latte leeiona are composed of fairly haavy dlsorwte oollagenous fibres and ^ oontala considerable aaouata of dust end sees esbestosie bodies. Thame assess .have oontraoted to produce sore .Or lsee stellate borders elthl radical strands extending Into tha surrounding alveolar walla. aatsaa^ Into theas aaesfs are tarmlnal bronohUae whose lumlne ery largely dlo^ Of aouree. the eseoelated branohee of the pulmonary artery dlao'oate^^ alas but there ham been ee aeoh contraction of tha soar klaaaa that toe PLAINTIFFS s charaet-rria11 o peritrongirlqlkr relatlnnattiixq^ are nnJlongei^. recognizable The sarcoid lesions -are mal T flbroua or^more rarely cellular nodulescontalnlrg one 'or more giant della,-- JU^ir.unao'apIlcalsd !oui they occur in lnteratltlaltlss'ue, the sheathe^ dfT5renchlT!*and bldfcd vessels and the alveolar and Interlobular septa. Ia addition. nodules are found at the sarglha of areaa of the duet fibrosis.Where the dust reaction la heaviest, especially beneath the pleura, the nodules an definitely within the aabeetotlc fibrous tlacue. ';y\- /~ ' The giant and eplthelold cells of the sarcoid show no evidence of degeneration aa evidenced. by fat staln&ble with Soharlach. R. They are surrounded by a delicate reticulum (black with Foot-Blelsakcnrskl) and at the periphery of the nodule are concentric banda of heavy non-hyalin collagen, xhe elaatla tissue Is probably pushed aside in the formation of nodules, ... Inclusion bodies In the giant dells of the sarcoid grsirologss are fairly numerous; those tnat oocur are largely of the round or oral orsnated ooncboldal type. These stain hlacic with hsaatozylln, red with the aold fushaln of Tan Qleson-Welgert instead of hlaak like elsstla tissue. Ton Koasa1 a calcium stain la negative. They glee a strong PrunejonBlue reaction for Iron. On testing other cases of saraold it found that in then also the inolualona contain iron and. oof slaatla or aalclua. Occasionally typical aabeatosla bodies are found within the Sardold nodules, The asbestosis bodies In the pneuaoconlotlo tissue reveal Barked and unusual modification In ferrooyanlfls preparations. Many of.tha bodies bare one or several very* large swellings either terminal or la the middle of the fibre. Bizarre forma develop abcrutr the partially aeparated bundles of aabretos. The oonoholdal rounded masses are mooli sore abundat hsre than within the sardold nodules, Muah of the gramra dust In the lesions Is apparently Iron, The blood vessels and bfonahlal tree, show nothing unusual except the sarcoid nodules in thiir sheaths. There Is no evidence of lnflaaaatory rsaotlon or pneumonia exudate ' 1TKPH SQDg3 -- Largely replaced by aarcoId nodules varying ltd*,, cellular to fibrous In oharaotsr, *o neoroaia. dLl show giant oslla vacuolated but no lncluslam bodies, Tarylng numbers of lymphooytsS in most of the lesions, BPt-ggi - A few small sardold nodules with giant aella but no ind bodies. - Sams no spleen. - B - 0 sardold; small fool of achlarosls with arteriolar