{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:06:17Z","timestamp":1791216377630,"version":"4.1.0"},"reference-count":234,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Asbestosis is defined as diffuse pulmonary fibrosis caused by the inhalation of excessive amounts of asbestos fibers. Pathologically, both pulmonary fibrosis of a particular pattern and evidence of excess asbestos in the lungs must be present. Clinically, the disease usually progresses slowly, with a typical latent period of more than 20 years from first exposure to onset of symptoms.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Differential Diagnosis: Idiopathic Pulmonary Fibrosis<\/jats:title>\n                    <jats:p>The pulmonary fibrosis of asbestosis is interstitial and has a basal subpleural distribution, similar to that seen in idiopathic pulmonary fibrosis, which is the principal differential diagnosis. However, there are differences between the 2 diseases apart from the presence or absence of asbestos. First, the interstitial fibrosis of asbestosis is accompanied by very little inflammation, which, although not marked, is better developed in idiopathic pulmonary fibrosis. Second, in keeping with the slow tempo of the disease, the fibroblastic foci that characterize idiopathic pulmonary fibrosis are infrequent in asbestosis. Third, asbestosis is almost always accompanied by mild fibrosis of the visceral pleura, a feature that is rare in idiopathic pulmonary fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Differential Diagnosis: Respiratory Bronchiolitis<\/jats:title>\n                    <jats:p>Asbestosis is believed to start in the region of the respiratory bronchiole and gradually extends outward to involve more and more of the lung acinus, until the separate foci of fibrosis link, resulting in the characteristically diffuse pattern of the disease. These early stages of the disease are diagnostically problematic because similar centriacinar fibrosis is often seen in cigarette smokers and is characteristic of mixed-dust pneumoconiosis. Fibrosis limited to the walls of the bronchioles does not represent asbestosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Role of Asbestos Bodies<\/jats:title>\n                    <jats:p>\n                      Histologic evidence of asbestos inhalation is provided by the identification of asbestos bodies either lying freely in the air spaces or embedded in the interstitial fibrosis. Asbestos bodies are distinguished from other ferruginous bodies by their thin, transparent core. Two or more asbestos bodies per square centimeter of a 5-\n                      <jats:italic>\u03bc<\/jats:italic>\n                      m-thick lung section, in combination with interstitial fibrosis of the appropriate pattern, are indicative of asbestosis. Fewer asbestos bodies do not necessarily exclude a diagnosis of asbestosis, but evidence of excess asbestos would then require quantitative studies performed on lung digests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Role of Fiber Analysis<\/jats:title>\n                    <jats:p>Quantification of asbestos load may be performed on lung digests or bronchoalveolar lavage material, employing either light microscopy, scanning electron microscopy, or transmission electron microscopy. Whichever technique is employed, the results are only dependable if the laboratory is well practiced in the method chosen, frequently performs such analyses, and the results are compared with those obtained by the same laboratory applying the same technique to a control population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5858\/134.3.462","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T12:12:03Z","timestamp":1613131923000},"page":"462-480","source":"Crossref","is-referenced-by-count":181,"title":["Pathology of Asbestosis\u2014An Update of the Diagnostic Criteria: Report of the Asbestosis Committee of the College of American Pathologists and Pulmonary Pathology Society"],"prefix":"10.5858","volume":"134","author":[{"given":"Victor L.","family":"Roggli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen R.","family":"Gibbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Attanoos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Churg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Popper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Cagle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Corrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teri J.","family":"Franks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francoise","family":"Galateau-Salle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Galvin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Hasleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas W.","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Honma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"11","key":"i1543-2165-134-3-462-b1","series-title":"Arch Pathol Lab Med","first-page":"544","article-title":"for Pneumoconiosis Committee of the College of American Pathologists and the National Institute for Occupational Safety and Health. 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London, EnglandHer Majesty's Stationery Office. 1898. 171."},{"key":"i1543-2165-134-3-462-b3","series-title":"Report and Minutes of Evidence","year":"1907","unstructured":"Departmental Committee on Compensation for Industrial Disease\n          \n          Report and Minutes of Evidence. London, EnglandHer Majesty's Stationery Office. 1907."},{"key":"i1543-2165-134-3-462-b4","series-title":"Trans Assoc Am Physicians","first-page":"97","article-title":"A roentgenologic study of the effects of dust inhalation of the lung.","volume":"32","author":"Pancoast, H. K.","year":"1917","unstructured":"Pancoast, H. K., T. G.Miller, and H. R. M.Landris. A roentgenologic study of the effects of dust inhalation of the lung.Trans Assoc Am Physicians1917. 32:97\u2013108."},{"issue":"3491","key":"i1543-2165-134-3-462-b5","series-title":"BMJ","first-page":"1024","article-title":"Pulmonary asbestosis.","volume":"2","author":"Cooke, W. E.","year":"1927","unstructured":"Cooke, W. 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Prospective study of mesothelioma mortality in Turkish villages with exposure to fibrous zeolite.J Natl Cancer Inst2006. 98 (6):414\u2013417."},{"issue":"1","key":"i1543-2165-134-3-462-b51","series-title":"Toxicol Lett","first-page":"251","article-title":"Lung diseases due to environmental exposures to erionite and asbestos in Turkey.","volume":"127","author":"Emri, S.","year":"2002","unstructured":"Emri, S., A.Demir, and M.Dogan. Lung diseases due to environmental exposures to erionite and asbestos in Turkey.Toxicol Lett2002. 127 (1):251\u2013257."},{"issue":"6","key":"i1543-2165-134-3-462-b52","series-title":"Br J Ind Med","first-page":"391","article-title":"Correlation between fibre content of the lungs and disease in naval dockyard workers.","volume":"43","author":"Wagner, J. C.","year":"1986","unstructured":"Wagner, J. C., C. B.Moncrieff, R.Coles, D. M.Griffiths, and D. E.Munday. Correlation between fibre content of the lungs and disease in naval dockyard workers.Br J Ind Med1986. 43 (6):391\u2013395."},{"key":"i1543-2165-134-3-462-b53","series-title":"Pathology of Asbestos-Associated Diseases. 2nd ed","first-page":"34","article-title":"Asbestos bodies and nonasbestos ferruginous bodies.","author":"Roggli, V. L.","year":"2004","unstructured":"Roggli, V. L.\n          \n          Asbestos bodies and nonasbestos ferruginous bodies.\n          In:\n          \n            \n              Roggli, V. L., T. D.Oury, and T. A.Sporn. Pathology of Asbestos-Associated Diseases. 2nd ed. New York, NYSpringer. 2004. 34\u201370."},{"issue":"3","key":"i1543-2165-134-3-462-b54","series-title":"Thorax","first-page":"327","article-title":"Analysis and interpretation of inorganic mineral particles in \u201clung\u201d tissues.","volume":"51","author":"Gibbs, A. R.","year":"1996","unstructured":"Gibbs, A. R. and F. D.Pooley. 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Asbestos content in lung tissue in asbestos associated disease: a study of 110 cases.Br J Ind Med1986. 153:444\u2013449."},{"issue":"suppl 5","key":"i1543-2165-134-3-462-b57","series-title":"Environ Health Perspect","first-page":"261","article-title":"Fibre levels and disease in workers from a factory using predominantly amosite.","volume":"102","author":"Gibbs, A. R.","year":"1994","unstructured":"Gibbs, A. R., M. J.Gardner, and F. D.Pooley. Fibre levels and disease in workers from a factory using predominantly amosite.Environ Health Perspect1994. 102 (suppl 5):261\u2013263."},{"issue":"11","key":"i1543-2165-134-3-462-b58","series-title":"Br J Ind Med","first-page":"767","article-title":"Mineral fibres, fibrosis, and asbestos bodies in lung tissue from deceased asbestos cement workers.","volume":"47","author":"Albin, M.","year":"1990","unstructured":"Albin, M., L.Johansson, and F. D.Pooley. 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New York, New YorkSpringer. 2004. 71\u2013103."},{"issue":"8","key":"i1543-2165-134-3-462-b102","series-title":"Hum Pathol","first-page":"688","article-title":"Small airway lesions in patients exposed to non-asbestos mineral dusts.","volume":"14","author":"Churg, A.","year":"1983","unstructured":"Churg, A. and J. L.Wright. Small airway lesions in patients exposed to non-asbestos mineral dusts.Hum Pathol1983. 14 (8):688\u2013693."},{"issue":"1","key":"i1543-2165-134-3-462-b103","series-title":"Environ Res","first-page":"232","article-title":"Asbestos bodies and the diagnosis of asbestosis in chrysotile workers.","volume":"39","author":"Holden, J.","year":"1986","unstructured":"Holden, J. and A.Churg. 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Proposed criteria for mixed dust pneumoconiosis: definition, descriptions, and guidelines for pathologic diagnosis and clinical correlation.Hum Pathol2004. 35:1515\u20131523."},{"issue":"3","key":"i1543-2165-134-3-462-b114","series-title":"Thorax","first-page":"324","article-title":"Electron microscopic studies in desquamative interstitial pneumonia associated with asbestos.","volume":"27","author":"Corrin, B.","year":"1972","unstructured":"Corrin, B. and A. B.Price. Electron microscopic studies in desquamative interstitial pneumonia associated with asbestos.Thorax1972. 27 (3):324\u2013331."},{"issue":"2","key":"i1543-2165-134-3-462-b115","series-title":"Am J Respir Crit Care Med","first-page":"277","article-title":"for American Thoracic Society\/European Respiratory Society International. Multidisciplinary consensus classification of the idiopathic interstitial pneumonias.","volume":"165","author":"Travis, W. D.","year":"2002","unstructured":"Travis, W. D., T. E.King, and E. 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R. and M. E.Gunter. A review of scientific literature examining the mining history, geology, mineralogy, and amphibole asbestos health effects of the Rainy Creek igneous complex, Libby, Montana, USA.Inhal Toxicol2006. 18 (12):949\u2013962."},{"issue":"suppl 1","key":"i1543-2165-134-3-462-b41","series-title":"Crit Rev Toxicol","first-page":"1","article-title":"Update of potency factors for asbestos-related lung cancer and mesothelioma.","volume":"38","author":"Berman, D. W.","year":"2008","unstructured":"Berman, D. W. and K. S.Crump. Update of potency factors for asbestos-related lung cancer and mesothelioma.Crit Rev Toxicol2008. 38 (suppl 1):1\u201347."},{"issue":"suppl 1","key":"i1543-2165-134-3-462-b42","series-title":"Crit Rev Toxicol","first-page":"49","article-title":"A meta-analysis of asbestos-related cancer risk that addresses fiber size and mineral type.","volume":"38","author":"Berman, D. W.","year":"2008","unstructured":"Berman, D. W. and K. S.Crump. 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Synthetic vitreous fibers: a review of toxicology research and its impact on hazard classification.Crit Rev Toxicol2001. 31 (1):1\u201353."},{"issue":"1","key":"i1543-2165-134-3-462-b45","series-title":"Toxicol Appl Pharmacol","first-page":"68","article-title":"The importance of fiber biopersistence and lung dose in determining the chronic inhalation effects of X607, RCF1, and chrysotile asbestos in rats.","volume":"153","author":"Hesterberg, T. W.","year":"1998","unstructured":"Hesterberg, T. W., G. A.Hart, J.Chevalier, and P.Thevenaz. The importance of fiber biopersistence and lung dose in determining the chronic inhalation effects of X607, RCF1, and chrysotile asbestos in rats.Toxicol Appl Pharmacol1998. 153 (1):68\u201382."},{"issue":"3","key":"i1543-2165-134-3-462-b46","series-title":"Regul Toxicol Pharmacol","first-page":"252","article-title":"The health effects of chrysotile: current perspective based upon recent data.","volume":"45","author":"Bernstein, D. M.","year":"2006","unstructured":"Bernstein, D. M. and J. A.Hoskins. The health effects of chrysotile: current perspective based upon recent data.Regul Toxicol Pharmacol2006. 45 (3):252\u2013264."},{"issue":"1","key":"i1543-2165-134-3-462-b47","series-title":"Am Rev Respir Dis","first-page":"25","article-title":"Fiber burden and patterns of disease in chrysotile miners and millers.","volume":"148","author":"Churg, A.","year":"1993","unstructured":"Churg, A., J. L.Wright, and S.Vedal. Fiber burden and patterns of disease in chrysotile miners and millers.Am Rev Respir Dis1993. 148 (1):25\u201331."},{"issue":"3","key":"i1543-2165-134-3-462-b48","series-title":"Am J Respir Crit Care Med","first-page":"663","article-title":"Fiber burden and patterns of asbestos-related disease in workers with heavy mixed amosite and chrysotile exposure.","volume":"150","author":"Churg, A.","year":"1994","unstructured":"Churg, A. and S.Vedal. 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Prospective study of mesothelioma mortality in Turkish villages with exposure to fibrous zeolite.J Natl Cancer Inst2006. 98 (6):414\u2013417."},{"issue":"1","key":"i1543-2165-134-3-462-b51","series-title":"Toxicol Lett","first-page":"251","article-title":"Lung diseases due to environmental exposures to erionite and asbestos in Turkey.","volume":"127","author":"Emri, S.","year":"2002","unstructured":"Emri, S., A.Demir, and M.Dogan. Lung diseases due to environmental exposures to erionite and asbestos in Turkey.Toxicol Lett2002. 127 (1):251\u2013257."},{"issue":"6","key":"i1543-2165-134-3-462-b52","series-title":"Br J Ind Med","first-page":"391","article-title":"Correlation between fibre content of the lungs and disease in naval dockyard workers.","volume":"43","author":"Wagner, J. C.","year":"1986","unstructured":"Wagner, J. C., C. B.Moncrieff, R.Coles, D. M.Griffiths, and D. E.Munday. Correlation between fibre content of the lungs and disease in naval dockyard workers.Br J Ind Med1986. 43 (6):391\u2013395."},{"key":"i1543-2165-134-3-462-b53","series-title":"Pathology of Asbestos-Associated Diseases. 2nd ed","first-page":"34","article-title":"Asbestos bodies and nonasbestos ferruginous bodies.","author":"Roggli, V. L.","year":"2004","unstructured":"Roggli, V. L.\n          \n          Asbestos bodies and nonasbestos ferruginous bodies.\n          In:\n          \n            \n              Roggli, V. L., T. D.Oury, and T. A.Sporn. Pathology of Asbestos-Associated Diseases. 2nd ed. New York, NYSpringer. 2004. 34\u201370."},{"issue":"3","key":"i1543-2165-134-3-462-b54","series-title":"Thorax","first-page":"327","article-title":"Analysis and interpretation of inorganic mineral particles in \u201clung\u201d tissues.","volume":"51","author":"Gibbs, A. R.","year":"1996","unstructured":"Gibbs, A. R. and F. D.Pooley. Analysis and interpretation of inorganic mineral particles in \u201clung\u201d tissues.Thorax1996. 51 (3):327\u2013334."},{"issue":"16","key":"i1543-2165-134-3-462-b55","series-title":"Eur Respir J","first-page":"1416","article-title":"European Respiratory Society. Guidelines for mineral fibre analyses in biological samples: report of the ERS Working Group.","volume":"11","author":"De Vuyst, P.","year":"1998","unstructured":"De Vuyst, P., A.Karjalainen, and P.Dumortier. European Respiratory Society. Guidelines for mineral fibre analyses in biological samples: report of the ERS Working Group.Eur Respir J1998. 11 (16):1416\u20131426."},{"key":"i1543-2165-134-3-462-b56","series-title":"Br J Ind Med","first-page":"444","article-title":"Asbestos content in lung tissue in asbestos associated disease: a study of 110 cases.","volume":"153","author":"Roggli, V. L.","year":"1986","unstructured":"Roggli, V. L., P. C.Pratt, and A. R.Brody. Asbestos content in lung tissue in asbestos associated disease: a study of 110 cases.Br J Ind Med1986. 153:444\u2013449."},{"issue":"suppl 5","key":"i1543-2165-134-3-462-b57","series-title":"Environ Health Perspect","first-page":"261","article-title":"Fibre levels and disease in workers from a factory using predominantly amosite.","volume":"102","author":"Gibbs, A. R.","year":"1994","unstructured":"Gibbs, A. R., M. J.Gardner, and F. D.Pooley. Fibre levels and disease in workers from a factory using predominantly amosite.Environ Health Perspect1994. 102 (suppl 5):261\u2013263."},{"issue":"11","key":"i1543-2165-134-3-462-b58","series-title":"Br J Ind Med","first-page":"767","article-title":"Mineral fibres, fibrosis, and asbestos bodies in lung tissue from deceased asbestos cement workers.","volume":"47","author":"Albin, M.","year":"1990","unstructured":"Albin, M., L.Johansson, and F. D.Pooley. Mineral fibres, fibrosis, and asbestos bodies in lung tissue from deceased asbestos cement workers.Br J Ind Med1990. 47 (11):767\u2013774."},{"issue":"3","key":"i1543-2165-134-3-462-b59","series-title":"J Clin Pathol","first-page":"224","article-title":"The optical and electron microscopic determination of pulmonary asbestos fibre concentration and its relation to the human pathological reaction.","volume":"26","author":"Ashcroft, T.","year":"1973","unstructured":"Ashcroft, T. and A. G.Heppleston. The optical and electron microscopic determination of pulmonary asbestos fibre concentration and its relation to the human pathological reaction.J Clin Pathol1973. 26 (3):224\u2013243."},{"issue":"3","key":"i1543-2165-134-3-462-b60","series-title":"J Clin Pathol","first-page":"313","article-title":"Comparison of the results of asbestos fibre counts in lung tissue obtained by analytical electron microscopy and light microscopy.","volume":"39","author":"Pooley, F. 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