Document zQ4Db7Dj6edBEjqJQxL07JYLg

Philip T. Cagle, M.D. Director Mary L. Ostrowski. M.D. Roberto Barrios, M.D. Center For Pulmonary Pathology BAYLOR COLLEGE OF MEDICINE DEPARTMENT OF PATHOLOGY ONE BAYLOR PLAZA, HOUSTON, TEXAS 77030 TELEPHONE: (713) 798-3671 FAX: (713) 798-3779 TAX ID* 74-1613878 May 4. 2000 8 am I ADDENDUM Mr. John Kurowski Kurowski & Bailey 12 Park Place Professional Centre Belleville (Swansea). IL 62221 RE: Cavanaugh. Fred (BYC00-039A) GROSS: Received are 7 paraffin blocks labeled A13-99. A section is cut from each of the blocks and stained with hematoxylin and eosin. Sections are then cut from one of the blocks representing tumor and immunostained for AE1/AE3, CAM 5.2. vimentin. CEA. calretinin. alpha actin. desmin. S100. CD31 and CD34. Also received are 13 containers of wet tissue, two of which contain lung parenchyma. Pooled samples of lung parenchyma from both containers are submitted for asbestos body count and EDXEA studies subsequent to digestion. Also received are records consisting of a death certificate, medical records from Baptist Health System including autopsy report 0I3-A-99NBH and medical records from Dr. Linda Ivy. HISTORY: See previous report BYC00-039. MICROSCOPIC: Review of the new H&E stained slides labeled A13-99 confirms the presence of a malignant spindle cell neoplasm involving the pleura and infiltrating the lung. The malignant cells are immunopositive for AEI/AE3. CAM 5.2 and vimentin on immunostains performed at Baylor College of Medicine. The malignant cells are immunonegative for CEA. calretinin, alpha actin, desmin, S100. CD31 and CD34 on immunostains performed at Baylor College of Medicine. In areas, the malignant cells are widely separated by dense fibrous tissue. I 1 PLAINTIFFS L EXHIBIT ; 1 CH-70 C-t L Addendum Consultation Report to Mr. John Kurowski RE: Cavanaugh. Fred (BYC00-039A) May 4. 2000 Page 2 COMMENT: Within reasonable medical probability, based on the gross distribution, routine histopathologic appearance and immunohistochemical stains, this man's malignancy is a desmoplastic sarcomatoid mesothelioma. Asbestos body count at Baylor College of Medicine discloses 124 asbestos bodies per gram of wet weight lung tissue, a level which is slightly above background in our laboratory and EDXEA discloses that the exposure to asbestos above background level was to amosite asbestos. Therefore, within reasonable medical probability, this man's mesothelioma can be attributed to exposure to amosite asbestos which is slightly above background (occupational level). Although some investigators believe that chrvsotile cannot cause mesothelioma at any level of exposure, other investigators have shown that chrysotile may cause mesothelioma when chrysotile is present in concentrations equivalent to those seen with asbestosis. the minimal level of which is in order of magnitude greater than the minimal level seen with amphibole induced mesothelioma. Chrysotile was not identified in the EDXEA study of this man's lungs. Within reasonable medical probability, this man's mesothelioma cannot be attributed to chrysotile exposure. DIAGNOSIS: Lung and pleura, autopsy: Desmoplastic sarcomatoid mesothelioma Philip T. Cagle. M.D. Pathologist PTC/sk