Holden J, Churg A
Environ Res. 1986 Feb;39(1):232-6. doi: 10.1016/s0013-9351(86)80024-x.
It has been suggested that because chrysotile asbestos forms asbestos bodies poorly, use of the traditional histologic requirements (diffuse interstitial fibrosis plus asbestos bodies) for the diagnosis of asbestosis, may lead to an underdiagnosis of this condition in workers exposed only to chrysotile. We examined lungs from 25 chrysotile miners with diffuse interstitial fibrosis. Asbestos bodies were found easily in histologic section using hematoxylin and eosin stains in all cases. Mineralogic analysis of four cases showed that 46 of 72 (64%) bodies isolated and examined contained chrysotile cores, and 21 of 72 (29%) bodies contained cores of the amphiboles tremolite and actinolite. By contrast, tremolite and actinolite constituted the majority of uncoated fibers in these cases. The mean length for bodies formed on chrysotile was 35 micron, and for bodies formed on tremolite or actinolite, 36 micron. We conclude that (1) the usual histologic criteria for the diagnosis of asbestos are applicable to chrysotile-exposed workers; (2) in workers with occupational chrysotile exposure, bodies form readily on this mineral; and (3) asbestos bodies in these lungs reflect the presence of long asbestos fibers.
有人提出，由于温石棉形成石棉小体的能力较差，使用传统的组织学标准（弥漫性间质纤维化加石棉小体）来诊断石棉沉着病，可能会导致仅接触温石棉的工人中该病的诊断不足。我们检查了25名患有弥漫性间质纤维化的温石棉矿工的肺部。在所有病例中，使用苏木精和伊红染色在组织切片中很容易发现石棉小体。对4例病例的矿物学分析表明，分离并检查的72个小体中有46个（64%）含有温石棉核心，72个小体中有21个（29%）含有闪石类透闪石和阳起石的核心。相比之下，在这些病例中，未被包裹的纤维多数是透闪石和阳起石。在温石棉上形成的小体平均长度为35微米，在透闪石或阳起石上形成的小体平均长度为36微米。我们得出结论：（1）诊断石棉沉着病的常用组织学标准适用于接触温石棉的工人；（2）在职业性接触温石棉的工人中，石棉小体很容易在这种矿物上形成；（3）这些肺部中的石棉小体反映了长石棉纤维的存在。
