Roggli et al reported finding Aspergillus fungal organisms in a fine-needle aspiration biopsy specimen of a right upper lobe mass in a shipyard electrical insulator. Roggli also mentioned five additional cases in which Aspergillus was identified in the lungs of persons occupationally exposed to asbestos. In case 6, there was no clinical evidence of allergic bronchopulmonary aspergillosis, and the patient was not asthmatic.
The granulomatous changes observed in the peripheral lung tissue from case 7 raised a fairly broad differential pathologic diagnosis. Histiocytic giant cells containing asbestos bodies are occasionally seen in the lungs of persons occupationally exposed to asbestos, as are occasional small nodular collections of histiocytes in association with asbestos bodies. In case 8, the granulomatous changes were much more extensive, somewhat resembling those seen in sarcoidosis. Although we cannot prove with absolute certainty that asbestos induced this granulomatous change, we believe that to be the case, since asbestos bodies were frequently identified in the granulomata, often within histiocytic giant cells of the granulomata, and there was no pathologic evidence of granulomatous lymphadenitis, no radiographic evidence of hilar or mediastinal adenopathy, and no pathologic evidence of granulomata in other tissues and organs. With respect to granulomatous inflammation induced by asbestos, Monseur et al reported a granulomatous inflammatory lesion in the urinary bladder neck of a patient working in an asbestos factory, that was initially diagnosed as tuberculosis, but after identification of asbestos fibers in the lesion tissue, was thought to be caused by asbestos.