[A case of asbestosis with long survival by artificial ventilation]

We treated a 63-year-old man in whom asbestosis developed after he had sprayed asbestos for 24 years. He was admitted with the chief complaint of dyspnea and was managed for 4 years with artificial ventilation. We believe that he survived for this long because he was free of severe pneumonia and because the lower lung, which is primarily affected by asbestos, was relatively intact so his pulmonary function did not deteriorate rapidly. Pathological findings included plate-like atelectasis in both upper lung fields and marked thickening of the pleura. Lung fibrosis was centrilobular but showed no honeycombing. The lung tissue contained 265 X 10(6) asbestos particles and 910 X 10(6) asbestos fibers per gram (dry weight), and the pleura also had 805 asbestos particles and 3,035 asbestos fibers. Most of these asbestos fibers were 20 microns or longer and were crocidolite.