[The theory of asbestos bodies
is dead - German mesothelioma register--What next?].
The requirement of 2 asbestos bodies per square centimeter did not originate with the 2010 committee, but was in fact proposed by the 1997 Helsinki consensus report and reaffirmed by the 2014 Helsinki meeting.
The critique claims that 2 asbestos bodies per square centimeter correspond to 4000 asbestos bodies per gram of wet lung tissue.
Presence of asbestos bodies
in organs other than the lung.
The electron microscopic evaluation is only done if no or remarkably few asbestos bodies
are found under the light microscope, but secondary lung changes like fibrosis, inflammation, putrefaction or autolysis are present, according to the current Helsinki Criteria .
While it is true that finding asbestos fibers or asbestos bodies
in lung tissue might provide evidence of asbestos exposure in cases where no exposure history or other proof of exposure is available, the detection of a certain number of asbestos fibers or asbestos bodies
in lung tissue cannot be made a universal requirement for confirming exposure to asbestos because such a requirement ignores two well established biological facts.
, Occupational disease, Lung fiber burden, Lung dust analysis, Lung cancer, Compensation
(1) The CAP criteria require "discrete foci of fibrosis in the walls of respiratory bronchioles associated with accumulations of asbestos bodies
in histological sections.'' The former criterion may be difficult to assess in cases with diffuse fibrosis and could overlap with other diseases showing similar changes, for example, respiratory bronchiolitis-associated interstitial lung disease or exposure to various dusts other than asbestos.
Although asbestosis is predominantly a lower lung disease radiographically, the presence of asbestos bodies
in regions of parenchymal fibrosis supports this diagnosis pathologically as outlined elsewhere in this paper.
The asbestos fibers, that had been found, were counted, i.e., both the encased fibers, the so-called asbestos bodies
, and separately free fibers without encasement were considered in the assessment especially if asbestos body counts were low.
The minimum criteria necessary for a diagnosis of asbestosis were the finding of "discrete foci of fibrosis in the walls of respiratory bronchioles associated with accumulations of asbestos bodies
" in histologic sections.
were observed on routine lung sections in 4 cases.