A biopsy series of mesotheliomata, and attempts to identify asbestos within some of the tumors

Our plain-English summary of A biopsy series of mesotheliomata, and attempts to identify asbestos within some of the tumors, by D.O. Hourihane (Annals of the New York Academy of Sciences, 1965).

The study

• Author: D.O. Hourihane
• Journal: Annals of the New York Academy of Sciences
• Published: 1965;132(1):647-73
• Cited by: 62 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy.

In plain English

This single-author article from The London Hospital Medical School had two parts. First, the author reviewed pathology files of the Bernhard Baron Institute of Pathology, London, from 1954 to July 1964, accepting 63 pleural and 11 peritoneal biopsies as mesotheliomata. The error in biopsy diagnosis for the 74 cases was about five per cent. All 11 cases later examined at necropsy were confirmed. Of 52 patients with follow-up information, all but three had died. Asbestos bodies were found in the lungs or sputum of 21 of 30 cases in which examination was possible. Second, slides were heated to burn away soft tissue and viewed by phase contrast microscopy. Probable asbestos fibers were found in 14 of 36 mesothelioma cases. Slides from eight cases of benign pleural plaques were also examined, and fibers were seen in one of the plaques. In a separate final investigation of most cases with no exposure history, asbestos was found in 4 of 19. The author judged the material almost certainly asbestos, probably an amphibole (crocidolite or amosite), noting that chrysotile is harder to see with this method.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of hospital biopsy (surgical pathology) files with patient follow-up, plus a laboratory examination of tumor slides by incineration and phase contrast microscopy to look for asbestos fibers
• Who was studied: 74 patients (63 pleural and 11 peritoneal biopsies accepted as mesotheliomata, 104 specimens in all) at the Bernhard Baron Institute of Pathology, London Hospital, 1954 to July 1964. Slides from 36 mesothelioma cases and from 8 cases of benign pleural plaques were examined for asbestos.
• Exposure: Asbestos as found in tissue: asbestos bodies in lungs or sputum, and rod-like fibers within pleural and peritoneal tumor tissue. The author considered the fibers probably amphibole asbestos (crocidolite or amosite). Occupational exposure histories were not measured in this article.
• Main results:
  • For the entire group of 74 cases, the error in biopsy diagnosis was of the order of five per cent.
  • In the 11 cases where necropsy was permitted, the diagnosis of mesothelioma was confirmed in each.
  • Information was received on 52 patients, and all but three had died. Death usually followed within one year of diagnosis.
  • Asbestos bodies were identified in the lungs or sputum of 21 cases out of 30 in which examination was possible.
  • From 1954 to July 1964, 58 acceptable pleural mesotheliomata were received, against 2,156 surgical lung carcinoma cases. Pleural mesotheliomata made up between 2 and 3 per cent of surgically biopsied malignant intrathoracic tumors.
  • After incineration, asbestos fibers were identified in 14 of the 36 mesothelioma cases examined, within tumor in parietal pleura and in peritoneum.
  • Pleural tumor: 24 slides from 18 patients were examined, and 7 slides from 7 patients contained asbestos fibers.
  • Peritoneal tumor: 32 slides from 21 patients were examined, and 8 slides from 7 patients contained asbestos fibers.
  • As a final, separate investigation, slides from most of the cases with no history of asbestos exposure were examined, and asbestos was found in 4 out of 19 cases (20 slides examined).
  • Slides from eight cases of benign pleural plaques were also incinerated, and asbestos fibers were seen in one of the plaques.
  • In summary, asbestos fibers were found in mesothelioma tissue in about one quarter of cases, and in about one half if only patients with asbestosis are considered.
• The authors' conclusion: The author concluded that it appears highly likely the structures found within the tumors are some type of asbestos, and that further work was being done to identify them. The author did not suggest that mesotheliomata always contain asbestos.
• Limitations the authors state:
  • The author states that necropsy examination is more certain than biopsy for diagnosing mesothelioma.
  • The author states that excluding metastatic carcinoma is probably more difficult in peritoneal biopsies.
  • In most earlier cases, before 1960, no examination for asbestos bodies was possible.
  • With the incineration technique, chrysotile is more difficult to see than the straight dark rods that were found.
  • The author's proposed explanation that asbestos reaches the pleura and peritoneum through the lymphatic system is described as not susceptible of proof.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Biopsy.

Related studies

• The pathology of mesotheliomata and an analysis of their association with asbestos exposure — D.O. Hourihane (1964)
• Cytotoxic effects of some mineral dusts on Syrian hamster peritoneal macrophages — E. Bey, J.S. Harington (1971)
• Asbestos-induced tumors in White Leghorn fowls — P.R. Peacock, A. Peacock (1965)
• CT-guided core-needle biopsy in omental pathology — F. Pombo, E. Rodriguez, et al. (1997)
• Surgical biopsy studies of omental and peritoneal nodules — D.B. Walsh, G. Williams (1971)
• Malignant peritoneal mesothelioma: a series of 19 cases — T. van Gelder, H.C. Hoogsteden, et al. (1989)

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