Miscetti Giorgio, Bodo Patrizia, Lumare A, Abbritti E P, Garofani Patrizia, Burani V
AZIENDA UNITA' SANTARIA REGIONE UMBRIA N.1 Perugia.
Med Lav. 2016 Jan 20;107(1):29-36.
In 2013 the International Journal of Surgical Pathology published a case report of intrasplenic malignant mesothelioma (MM) in a 48-year-old man: it was the first report in literature describing a case of primitive intra-splenic MM, described without a history of asbestos exposure.
To verify the possible past exposure to asbestos, ignored by the patient himself, by studying in depth his environmental and occupational history.
Information about the occupational and non-occupational history of the subject was collected by Experts of the Operational Unit of Occupational Health and Safety Control (UOC PSAL) of the Local Health Unit Umbria 1 - Perugia, using the Italian National Mesothelioma Register (ReNaM) questionnaire and guide lines; an inspection was carried out at the past canning industry where the patient worked in the period 1982-1990 and material was taken to be analysed by MOCF and SEM.
Samples showed the presence of asbestos fibres belonging to the amphibole class (amosite and crocidolite) and to the serpentine class (chrysotile).
The survey described the past occupational exposure to asbestos in a canning industry, where the subject worked in the period 1982-1990, unknown to the patient himself. The authors strongly confirm the usefulness of standardized methods, such as the ReNaM Questionnaire, and the importance of technical expertise of the investigator to find and analyse the suspect materials and to demonstrate possible past occupational exposure to asbestos.
2013年，《国际外科病理学杂志》发表了一例48岁男性脾内恶性间皮瘤（MM）的病例报告：这是文献中首例描述原发性脾内MM且无石棉接触史的病例报告。
通过深入研究患者的环境和职业史，核实患者本人未提及的过去可能接触石棉的情况。
翁布里亚大区1 - 佩鲁贾地方卫生单位职业健康与安全控制运营单位（UOC PSAL）的专家使用意大利国家间皮瘤登记册（ReNaM）问卷和指南，收集了该患者职业和非职业史的信息；对患者在1982 - 1990年期间工作过的罐头厂进行了检查，并采集了材料，送去进行微纤丝计数荧光法（MOCF）和扫描电子显微镜（SEM）分析。
样本显示存在属于闪石类（铁石棉和青石棉）和蛇纹石类（温石棉）的石棉纤维。
该调查描述了患者在1982 - 1990年期间工作过的罐头厂存在过去职业性石棉接触情况，而患者本人并不知晓。作者强烈肯定了标准化方法（如ReNaM问卷）的实用性，以及调查人员专业技术在查找和分析可疑材料、证明过去可能的职业性石棉接触方面的重要性。
