The case report of a male patient who developed pulmonary fibrosis after exposure to fiberglass for 41 years was presented. He had worked as a carpenter, and had packed fiberglass insulation into wall and roof spaces. A chest radiograph revealed shadows in the lungs, pleural adhesions in the upper lung fields, nodular shadows in the lower lung fields, and abnormal diaphragm margins. A computed tomograph (CT) also revealed nodular opacities in the lower lung fields and cystic lesions and low attenuation areas in the upper lung fields. Pulmonary function values ranged from 48 to 112% of the predicted values. Examination of a lung tissue sample with an electron microscope (EM) revealed fibrosis and an influx of lymphoid cells into the alveolar septa. Mineral analysis of the small, nonstructural substances discovered in the lung with an analytical electron microscope (AEM) indicated an elemental composition similar to that of glass fibers. An average of 20 fibers in every two or three fields was determined. The authors conclude that this patient's heavy smoking history and long term exposure to fiberglass have contributed to pulmonary fibrosis. The authors recommend the use of the EM and the AEM for the intensive examination of lung tissue.

Support: Paper