Pleural Mesothelioma in a Woman Whose Documented Past Exposure to Asbestos was From Smoking Asbestos-Containing Filtered Cigarettes: The Comparative Value of Analytical Transmission Electron Microscopic Analysis of Lung and Lymph-Node Tissue

Abstract

Asbestos has had many commercial applications, including its use as a major component in various types of filters. Between 1952 and 1956, crocidolite asbestos was used as a component of filters for cigarettes, reportedly greatly reducing tars and nicotine from mainstream smoke. This case report quantifies asbestos burden in lung and lymph node tissue in a 67-yr-old woman who succumbed to mesothelioma. Her only historically documented exposure to asbestos was from smoking crocidolite asbestos-containing filtered cigarettes between 1952 and 1956. Tissue digestion analysis by analytical transmission electron microscopy (ATEM) identified crocidolite fibers in lungs and thoracic lymph nodes. Combined ATEM data of lung and lymph node tissue clarified the patient's exposure to asbestos and particularly to crocidolite asbestos and thus to the presence of an entity recognized as the causal agent for mesothelioma.

Crocidolite and Mesothelioma

“…In the past, though, we have not identified crocidolite fibers in lung tissue samples from 4 individuals who described exposure to crocidolite from Micronite filter cigarettes [8]. Dodson et al reported fiber analysis results from 3 patients who smoked Kent cigarettes [27,28]. Crocidolite was detected in 2, but amosite was detected in all 3 cases.…”

Asbestos-related cancers: the ‘Hidden Killer’ remains a global threat

“…Thirty years later it was found that of the 33 people who had worked in the filter factory, 15 had died from cancer (including 8 lung cancer cases and 5 mesotheliomas; relative risk 8.2; 95% Confidence Interval: 4.6-13.4) and 5 from asbestosis [47]. The development of mesothelioma following smoking of asbestosfiltered cigarettes has also been documented [48].…”

Malignant Mesothelioma: Mechanism of Carcinogenesis

“…However, fiber biopersistence in the pleura is not documented; in particular, there are no data on the relationship between biopersistence in the lung and translocation of fibers from the lung to the pleura, nor on the pleural clearance of fibers following inhalation [97,98].…”