Figures
- Fig. 1—
a) Aggregation of phagocytes in the alveolar space, swollen and widened alveolar septums, and pulmonary fibrosis were observed (haematoxylin-eosin (HE) stain). b) Effusion of inflammatory cells was observed in tunica mucosa bronchiorum (HE stain). c) Pathological examination of the pleura showed foreign-body granulomas with fibrinous and inflammatory cell effusions (HE stain). Arrows indicate foreign body giant polykaryocytes. d) Pathological examination of the pleural membrane 18 months later showed fibrous thickening and swelling, fibroblast proliferation, cellulosic exudate and lymphocyte aggregation (HE stain). e) Pulmonary pathological examination 18 months later showed the alveolar septum was widened with blood vessel dilatation and congestion. Pulmonary alveoli were partly emphysematous with scattered multinucleated giant cells (HE stain). a, d) Scale bars = 50 μm. b, c, e) Scale bars = 25 μm.
- Fig. 2—
a) Nanoparticles (indicated by arrows) in chest fluid. Round nanoparticles ∼30 nm in diameter were scattered in the fluid, being wrapped up by fibrous structure, which may have originated from cytolysis in pleural fluid. b) Clusters of nanoparticles (30 nm in diameter) were observed to lodge in the caryoplasm of a pulmonary epithelial cell. c) With nanoparticles lodging in the cytoplasm and caryoplasm of the pulmonary epithelial cell, the chromatin had condensed and marginalised like a crescent, showing characteristic cell morphology of cells undergoing apoptosis. d) Clusters of nanoparticles were obviously found when the highlighted section of c) was enlarged. a, b) Scale bars = 200 nm. c, d) Scale bar = 500 nm.
Tables
- Table 1—
Patients’ characteristics
Case Age yrs Sex Duration of exposure months PO2 kPa Pleural effusion Pericardial effusion Bronchoscopy Thoracoscopy VATS Outcome 1 29 Female 13 9.6 Great Small + + - Died 2 47 Female 11 10.5 Great None + + - Stable 3 18 Female 13 9.6 Great Small + + + Stable 4 29 Female 12 11.6 Great Small + - - Stable 5 19 Female 10 10.7 Great Small + - + Died 6 35 Female 10 12.9 Great Small + - - Stable 7 28 Female 5 12.9 Small None + - - Stable PO2: oxygen tension; VATS: video-assisted thoracic surgery. +: performed; -: not performed.
- Table 2—
White blood cell count(WBC) changes, differential counts and the related laboratory items in the initial stage
WBC ×109·L Neutrophilic granulocyte % Neutrophilic count ×109·L−1 Monocyte % Monocyte counts ×109·L−1 Platelet counts ×109·L−1 ESR mm·h−1 CRP mg·L−1 ALT U·L−1 AST U·L−1 Normal range 4.0–10.0 50.0–70.0 2.0–7.0 3–8 0.12–0.80 100–300 0–20 <10 10–40 10–42 Case 1 5.83 34.1 2.89 24.5 1.49 210 26 <8 25 21 2 4.15 37.8 1.74 16.5 0.82 150 6 56 30 20 3 6.39 35.5 2.24 16.3 1.44 254 28 <8 17 63 4 4.86 32.6 1.58 9.6 0.45 51 53 <8 73 70 5 6.98 24.5 1.71 13.3 0.96 201 30 <8 42 59 6 5.66 63.5 3.6 7.2 0.41 206 12 <8 20 18 7 5.32 63.6 3.39 6.8 0.36 100 22 <8 15 30 ESR: erythrocyte sedimentation rate; CRP: C- reactive protein; ALT: alanine aminotransferase; AST: aspartate aminotransferase.
Supplementary figures
Patient CT scans
Files in this Data Supplement:
- Supplementary figure 1 - Case 5 at presentation
- Supplementary figure 2 - Case 5 after 2 months
- Supplementary figure 3 - Case 5 after 4 months
- Supplementary figure 4 - Case 5 after 10 months
- Supplementary figure 5 - Case 5 at 12 months
- Supplementary figure 6 - Case 5 after 18 months
- Supplementary figure 7 - Case 2 at presentation
- Supplementary figure 8 - Case 2 after 15 months
- Supplementary figure 9 - Case 4 at presentation
- Supplementary figure 10 - Case 4 after 2 months
- Supplementary figure 11 - Case 4 after 15 months
