Ferruginous body

Ferruginous body is a histopathologic finding in lung pathology that strongly suggests exposure to asbestos.

File:Ferruginous bodies - BAL - r3 -- very high mag.jpg

Ferruginous body in a BAL. (WC)

General

• Uncommon finding.
• Strongly suggestive of asbestos exposure.

Conditions associated with asbestos exposure (mnemonic PALM):

• Pleural plaques.
• Asbestosis.
• Lung carcinoma.
• Malignant mesothelioma.

Microscopic

Features:

• Segmented twirling baton-like structure (approximately 3-5 micrometres x 20-80 micrometres) with long slender fibre within.
• Black/brown crystal-like appearance.

DDx:

• Dirt - especially on H&E.

Images

• Ferruginous body.jpg

  Ferruginous bodies. (WC)

Cytology

• Ferruginous bodies - BAL - r1 -- high mag.jpg

  FB - high mag. (WC)

• Ferruginous bodies - BAL - r1 -- very high mag.jpg

  FB - very high mag. (WC)

• Ferruginous bodies - BAL - r2 -- very high mag.jpg

  FB - very high mag. (WC)

• Ferruginous bodies - BAL - r3 -- high mag.jpg

  FB - high mag. (WC)

• Ferruginous bodies - BAL - r3 -- very high mag.jpg

  FB - very high mag. (WC)

• Carcinoma asbestos body lung.jpg

  Ferruginous body in carcinoma - cytology. (WC/Alex Brollo)

Stains

• Prussian blue stain +ve.

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Comment:
No cell block is available for further work-up, e.g. iron staining.

The findings herein should be correlated with imaging and the clinical history. 
Ferruginous bodies are associated asbestos exposure.

See also

• Malignant mesothelioma.