The utility of electron microscopy in detecting asbestos fibers and particles in BALF in diffuse lung diseases

BMC Pulmonary Medicine

Research Article

Yasuo Morimoto¹  Takaaki Ogoshi²  Takashi Kido²  Hiroshi Ishimoto²  Hiroshi Mukae²  Kazuhiro Yatera²  Kei Yamasaki²  Toshinori Kawanami²  Keishi Oda²  Shohei Shimajiri³ 

[1] Department of Occupational Pneumology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan;Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan;Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, Japan;

关键词: Asbestos;    Bronchoalveolar lavage;    Diffuse lung diseases;    Electron microscopy;    Elements;    Light microscopy;    Occupational exposure;   

DOI  :  10.1186/s12890-017-0415-5

 received in 2016-09-27, accepted in 2017-04-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn patients with diffuse lung diseases, differentiating occupational lung diseases from other diseases is clinically important. However, the value of assessing asbestos and particles in bronchoalveolar lavage fluid (BALF) in diffuse lung diseases by electron microscopy (EM) remains unclear. We evaluated the utility of EM in detecting asbestos fibers and particles in patients with diffuse lung diseases.MethodsThe BALF specimens of 107 patients with diffuse lung diseases were evaluated. First, detection of asbestos by EM and light microscopy (LM) were compared. Second, the detection of asbestos using surgically obtained lung tissues of 8 of 107 patients were compared with the results of EM and LM in BALF. Third, we compared the results of mineralogical components of particles in patients with (n = 48) and without (n = 59) a history of occupational exposure to inorganic dust.ResultsBALF asbestos were detected in 11 of 48 patients with a history of occupational exposure by EM; whereas asbestos as asbestos bodies (ABs) were detected in BALF in 4 of these 11 patients by LM. Eight of 107 patients in whom lung tissue samples were surgically obtained, EM detected BALF asbestos at a level of >1,000 fibers/ml in all three patients who had ABs in lung tissue samples by LM at a level of >1,000 fibers/g. The BALF asbestos concentration by EM and in lung tissue by LM were positively correlated. The particle fractions of iron and phosphorus were increased in patients with a history of occupational exposure and both correlated with a history of occupational exposure by a multiple regression analysis.ConclusionsEM using BALF seemed to be superior to LM using BALF and displayed a similar sensitivity to LM using surgically-obtained lung tissue samples in the detection of asbestos. Our results also suggest that detection of elements, such as iron and phosphorus in particles, is useful for evaluating occupational exposure. We conclude that the detection of asbestos and iron and phosphorus in particles in BALF by EM is very useful for the evaluation of occupational exposure.

【 授权许可】

CC BY   
© The Author(s). 2017