Asbestos fiber identification in liver from cholangiocarcinoma patients living in an asbestos polluted area: a preliminary study

Abstract

Purpose: To assess whether asbestos fibers may be observed in liver tissue of patients with cholangiocarcinoma (CC) with environmental or working asbestos exposure. Methods: Detection of fibers was performed directly on histologic sections of liver from 7 patients with CC using optical microscope and variable pressure scanning electron microscopy equipped with energy-dispersive spectroscopy (VP-SEM/EDS). All patients were from Casale Monferrato, Italy, a highly asbestos-polluted town. Due to ethical constraints, observers were blinded to patients’ clinical features. Results: Fibers/bundles of fibers of chrysotile were detected in 5 out of 7 patients (71%). The boundary between healthy and neoplastic tissue or the fibrocollagen tissue produced by the neoplasia were identified as areas of fiber incorporation. Conclusions: This study is the first report about the detection of chrysotile asbestos fibers in the liver of patients with CC. Further studies on larger cohorts are needed to corroborate our preliminary findings.

Asbestos Fibers and Ferruginous Bodies Detected by VP-SEM/EDS in Colon Tissues of a Patient Affected by Colon-Rectum Cancer: A Case Study

“…In parallel, three 5-µm-thick non-stained sections from paraffin-embedded blocks were prepared for VP-SEM/EDS analysis. The sections were prepared on plastic slides, as described previously [10,11,13,23], which are free from interference with the chemicals constituting the asbestos minerals-i.e., Si, Mg, Na, Fe, Ca. Therefore, any detected chemical elements were attributable to the observed inorganic phases.…”

“…A strong correlation between inhaled fibers of these minerals and the development of severe respiratory diseases, such as malignant pleural mesothelioma, pulmonary carcinoma and asbestosis, has been demonstrated in multiple reports [1][2][3][4][5][6][7][8][9]. Moreover, several recent Minerals 2021, 11, 658 2 of 11 studies described the presence of asbestos fibers in the gallbladder and in the liver of patients with severe diseases in the upper part of the gastro-intestinal system or with cholangiocarcinoma [10][11][12][13]. On the other hand, the relationship between cancers of laryngeal and ovarian peritoneum and asbestos has also been recognized by the IARC [14], but the correlation between asbestos and gastrointestinal cancers has not been completely clarified [15].…”

Asbestos and Intrahepatic Cholangiocarcinoma

“…The first study reporting the detection of asbestos fibers in the biliary tract refers to a patient with asbestosis; post-mortem examination revealed a cancer arising from the cystic duct with short asbestos bodies and fragments with a similar shape of those observed in the lung [66]. More recently, the deposition of asbestos fibers in the biliary tract has been confirmed by some studies of Grosso et al [67][68][69][70]. In the first explorative study, five patients living in Casale Monferrato (a well-known asbestos-polluted Italian city) undergone surgery for gallbladder stones were analyzed [67].…”

“…A high concentration of fibers has been also detected in the gallbladders of patients environmentally/occupationally exposed to asbestos, who suffered of severe bile tract diseases and died of MPM [68,69]. The presence of fibers/bundles of chrysotile has been also detected in five out of seven patients (71%) from Casale Monferrato affected by ICC; fibers incorporation occurred at the boundary between the healthy and neoplastic hepatic tissue or in fibrocollagen tissue produced by the neoplasia [70]. Notably, chrysotile was the only type of fibers observed in the liver, whereas in the gallbladder of patients with MPM also crocidolite was detected [68,69]; this observation is likely related to the easier translocation in extrapulmonary sites for serpentines, whose fibers are thinner than amphiboles [72].…”

Micro-Raman Spectroscopy, a Powerful Technique Allowing Sure Identification and Complete Characterization of Asbestiform Minerals

“…It is now universally accepted the noxious role of the asbestos on the human health. Asbestos fibers in the human body can be detected not only in the respiratory system, when inhaled [18,37,38], but also in other organs or tissues [39][40][41][42][43], attained by translocation or ingestion processes. Considering that recent studies demonstrated its presence in unexpected places, in paintings as an example [44], it is therefore very important to find a technique allowing an easy identification of the fibers in different matrixes.…”