Document ymbkMnVR7k31J2LOKVjZ5ynr3

FILE NAME: RT Vanderbilt (RTV) DATE: 1989 Jan DOC#: RTV042 DOCUMENT DESCRIPTION: Letter from Pathology Dept, at Mercy Hospital documenting "markedly fibrotic honeycombed lungs with Extensive Metaplasia. Marked Evidence of Talcosis & Asbestosis." State University otlSiew 9ork Health Science Center College of Medicine Department of Pathology r'AA ij'.i 1JO -joUU.il"'.' . , lV8 9 Paul Malek, M.D. Pathology Department Mercy Hospital 218 Stone Street . Watertown, New York 13601 Re: Murray Baker, Autopsy #A-89-G-3 . - JA89-196 Dear Paul: Thank you for preparing and sending the lung tissue samples for my review and use in teaching. These specimens have already been quite educational to the pathology staff, residents and medical students, and have been a welcome addition to my research study of the talc miners. My observation of the lung samples revealed markedly-fibrotic, focally honeycombed lungs with extensive epithelial metaplasia. There is marked evidence, of talcosis and asbestosis. Pleural plaques were described by you in the autopsy report. The mass in the posterior, superior portion of the right lower lebe microscopically is a poorly differentiated adenocarcinoma with focal irtracytoplasmic positivity for mucin. Your autopsy report described metastatic disease to lymph nodes, liver and adrenal glands bilaterally. I did not receive any sections to document the metastatic disease and would appreciate a recut slide of these to complete my records on the case if possible. The lung tissue fiber analysis revealed markedly elevated concentrations of asbestos fibers of the type associated with the talc mine. These are mostly anthophyllite with some tremolite and lesser amounts of chrysotile. . In addition high concentrations of talc fibers were identified. No amosite or crocidolite asbestos fibers were identified. _______. Looicing-.forwar-d^-fe-o^h&ar-fng--f u i Llier~~f rom ygOG B e s t r e g a r d s . Sincerely, Jerrold L. Abraham, M D .. ,, Associate Professor and Director of Environmental and Occupational Pathology -..-- --' JLA/cd Enclosure cc: Victor Ciabotti, Esq. A Center for Professional Education, Patient Care and Research. iliidc of Meilki College ot Graduate Studies College of Health Related Professions-' H ^igiiS! 7 S 0 F2*c* C*e**o* C> iSt^U niversity Hospital state University of New Uork Health Science Centex Syracuse so " College of Medicine Department of Pathology (315) 464-4750 FAX (315) 464-7130 J a n c s a r y 2 , 10 89 Paul Malek, M.D. Pathology Department Mercy Hospital 218 Stone Street Watertown, New York 13601 Re: Murray Baker, Autopsy #A-89-G-3 JA89-196 Dear Paul: Thank you for preparing and. sending the lung tissue samples for my review and use in teaching. These specimens have already been quite educational to the pathology staff, residents and medical students, and have been a welcome addition to my research study of the talc miners. My observation of the lung samples revealed markedly fibrotic, focally honeycombed lungs with extensive epithelial metaplasia. There is marked evidence of talcosis and asbestosis. Pleural plaques were described by you in the autopsy report. The mass in the posterior, superior portion or tne right TowerToBe' microscopically is a poorly differentiated adenocarcinoma with focal intracytop1asmic positivity for mucin. Your autopsy report described metastatic disease to lymph nodes, liver and adrenal glands bilaterally. I did not receive any sections to document the metastatic disease and would appreciate a recut slide of these to complete my records on the case if possible. The lung tissue fiber analysis revealed markedly elevated concentrations of asbestos fibers of the type associated with the talc mine. These are mostly anthonhyllite with some tremolite and lesser amounts of chrysotile. In addition high conr.p.nrratione of t a i n fibers were identified-- No amosite or-crocidolite asbpgrog fihaxa-weie 1iluufelfi ed. Looking forward to hearing further from you. Best regards. Sincerely, Jerrold L. Abraham, M.D. Associate Professor and Director of Environmental and Occupational Pathology JLA/cd Enclosure cc: Vicetor Ciabotti, Esq. A Center for Professional Education. Patient Care and Research. College of Medicine College of Graduate Studies College of Health Related Professions College of Nursing 750 Ei\i Adams Sireei, Syracuse. N.Y. 13210 University Hospital ASBESTOSIS. TALCOSIS, MESOTHELIOMA AND NOM-COMMERCIAL AMPHIBOLE ASBESTOS FIBERS AND CLEAVAGE FRAGMENTS IN LUNC TISSUES OF NEU YORK STATE TALC MINERS. Abraham. J.L.: Department of Pathology, State UnLversity of New York, Syracuse, New York, USA. New York State talc miners have been exposed to a complex mixture of respirable dust, and the resulting pneumoconiosis has been known for decades. However, the documentation of pulmonary asbestosis and mesothelioma and the correlation with exposure history and with the mineralogy of the lung tissue burden has been scant. Consequently, as part of an ongoing study, using electron microprobe analysis I have analyzed the autopsy lung fiber and nonfibrous particulate burden in eight miners (including one with mesothelioma and one with a lung scar adenocarcinoma). The results presented in the Table show that the asbestos fiber types found in high concentration in the miners are the types found in association with NY State talc joining. A variable fraction of the fibers had morphology consistent with cleavage fragments. High concentrations of commercial amphibole asbestos were not found in these cases (low concentrations were found in cases 1, 2 and 5). Thus, the asbestosrelated diseases seen in these miners are related to non-commercial amphiboles. Case_____________ 1 2 3 4 5 678 Age 71 76 58 60 71 63 58 66 Yrs Mining 2 10 21 18 25 30 22 23 #Diagnoses N1 Pn ATS ATP ATP ATSP ATM ATPC gAsb, Bodies 0.1 1.0 1.0 98. 485. 89. 35. 42. *Asb. Fibers AnthophylLite 0.04 0.4 85. 64. 49. 99. 5. 14. o.ia Tremolite/Act. 0.07 0.7 105. Cbrysotile 2.7 188. *Talc Fibers 0.1 3.1 716. 7. 34. 10. 19. 47. 184. 12. 0.2 31. 17. 5. 9. 66. 46. 195. Talc (nonfibrous) 1. 1. 60. na 51. 139. na na Silica 1. 1. 10. na nd 68. na na # N1 (normal); Pn (Pneumonia); A (asbestosis); T (talcosis); S (silicosis); P (pleural plaques); M (mesothelioma);C (lung cancer). 8 (tens of thousands of bodies/gram dry lung) * (millions of fibers/gram dry lung) + (millions of nonfibrous partlcles/ml lung) na (not available); nd (not detected)