Uibu Toomas, Vanhala Esa, Sajantila Antti, Lunetta Philippe, Mäkelä-Bengs Päivi, Goebeler Sirkka, Jäntti Matti, Tossavainen Antti
Department of Respiratory Medicine, Tampere University Hospital, Tampere, Finland.
Am J Ind Med. 2009 Jun;52(6):464-70. doi: 10.1002/ajim.20694.
Asbestos fibers are known to accumulate in lung parenchyma and thoracic lymph nodes, but their presence and translocation into the extrapulmonary tissues need clarification. We assessed the presence of asbestos in the para-aortic (PA) and mesenteric (ME) lymph nodes.
PA and ME lymph nodes and lung tissue from 17 persons who underwent medicolegal autopsy for suspicion of asbestos-related disease and from five controls were analyzed for asbestos fibers using transmission electron microscopy.
High concentrations of amphibole asbestos fibers were detected in several lung tissue samples and in the respective PA and ME lymph nodes. The mean concentration for the 10 persons with a lung asbestos content of >/=1 million fibers/g of dry tissue (f/g) was 0.85 (<0.05-4.36) million f/g in the PA lymph nodes and 0.55 (<0.02-2.86) million f/g in the ME lymph nodes. The respective mean values for the 12 persons with a lung asbestos concentration of <1 million f/g were 0.07 for the PA lymph nodes and 0.03 million f/g for the ME nodes. The lung asbestos burden that predicted the detection of asbestos in abdominal lymph nodes was 0.45 million f/g.
In addition to their accumulation in lung tissue, asbestos fibers also collect in the retroperitoneal and the mesenteric lymph nodes. Even low-level occupational exposure results in the presence of crocidolite, amosite, anthophyllite, tremolite, or chrysotile in these abdominal lymph nodes. Our results support the hypothesis of lymph drainage as an important translocation mechanism for asbestos in the human body.
已知石棉纤维会在肺实质和胸内淋巴结中蓄积,但其在肺外组织中的存在及转移情况尚需阐明。我们评估了主动脉旁(PA)和肠系膜(ME)淋巴结中石棉的存在情况。
对17例因怀疑患有石棉相关疾病而接受法医尸检的患者以及5例对照者的PA和ME淋巴结及肺组织进行透射电子显微镜检查,以分析石棉纤维。
在多个肺组织样本以及相应的PA和ME淋巴结中检测到高浓度的闪石类石棉纤维。肺石棉含量≥100万纤维/克干组织(f/g)的10例患者,PA淋巴结中的平均浓度为0.85(0.05 - 4.36)万f/g,ME淋巴结中的平均浓度为0.55(0.02 - 2.86)万f/g。肺石棉浓度<100万f/g的12例患者,PA淋巴结的相应平均值为0.07,ME淋巴结为0.03万f/g。预测腹部淋巴结中石棉检测的肺石棉负荷为45万f/g。
除了在肺组织中蓄积外,石棉纤维也会在腹膜后和肠系膜淋巴结中聚集。即使是低水平的职业暴露也会导致这些腹部淋巴结中存在青石棉、铁石棉、直闪石、透闪石或温石棉。我们的结果支持淋巴引流是石棉在人体中重要转移机制的假说。