Path. Res. Praet. 185, 178-179 (1989)

A Focal Fibrotic Reaction of the Lung

K.-M. MullerInstitut fOr Patho/ogie, Berufsgenossenschaftl. Krankenanstalten "Bergmannsheil"Ruhruniversitat Bochum, FRG

Case History

56-year-old carpenter, from time to time occupied withsawing cement asbestos pieces, had been awarded an earlypension on account of chronic lung disease (COPD).

X-Ray

Over the last 10 ye'ars a moderate proliferation of thestructural composition was observed in both middle partsof the lung, depending on neoangiogenesis. The lowerparts were poorly structured. A general increase of heartsize was noted over the last 7 years. The· pulmonaryprocess was unclassified, there were no distinct changes ofthe pleura.

The patient died under clinical signs of general respira­tory insufficiency with right heart failure.

Autopsy Examination

Focal lung fibrosis, older pulmonary embolisms andinfarcts, chronic bronchitis with emphysema, moderatepulmonary sclerosis. Extreme chronic cor pulmonale.Signs of right heart failure. Qualitative and quantitativeanalyses of lung tissue dust assessed 180 asbestos bodiesper cubic em.

Questions: 1) Diagnosis?2) Differential diagnosis with specified argu­

mentation!3) Etiology, pathogenesis, prognosis?

Deadline: October 16, 1989 (Answers should be sent tothe author of the Expert Quiz)

Author's address: Prof. Dr. Klaus-Michael Muller, Institut fur Pathologie, Krankenanstalten Bergmannsheil,Gilsingstr. 14, D-4630 Bochum 1

0344-0338/89/0185-0178$3.50/0 © 1989 by Gustav Fischer Verlag, Stuttgart

A Focal Fibrotic Reaction of the Lung . 179

Fig. 1. Left upper part: Fibrotic focus of the lung, Elastica-van Gieson, 215 x. - Right upper part:Another fibrotic focus, same case. Prussian Blue SE 215 x. - Bottom: Area of non-fibrotic lung tissue.Prussian Blue SE, 137x.