Association of lymphocytic neoplasia and mesothelioma

Our plain-English summary of Association of lymphocytic neoplasia and mesothelioma, by A.P. Efremidis, J.S. Waxman, A.P. Chahinian (Cancer, 1985).

The study

• Authors: A.P. Efremidis, J.S. Waxman, A.P. Chahinian
• Journal: Cancer
• Published: 1985;55(5):1056-9
• Type of article: Case report
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001231).

Abstract

Two lymphocytic neoplasms, chronic lymphocytic leukemia and poorly differentiated lymphoma, were detected in two patients who had nonoccupational exposure to asbestos. Both had a pleural mesothelioma subsequent to their initial presentation with lymphocytic neoplasm. Recent reports have suggested a possible association between asbestos exposure and lymphoproliferative neoplasms. Chronic antigenic stimulation by asbestos could predispose one to the immunoproliferative disorders seen in these patients. The possible significance of this relationship is discussed for future consideration.

In plain English

This case report described two New York men who each had a lymphocytic cancer and later pleural mesothelioma. The first, a 75-year-old retired building superintendent, was diagnosed with chronic lymphocytic leukemia in 1982. A bone marrow biopsy later showed mesothelioma beside leukemia cells, pleural biopsy confirmed fibrous sarcomatous mesothelioma, and he died within a month. His only reported possible asbestos source was several months of clerical work in Navy yards during World War II. The second, a 61-year-old shop teacher, had poorly differentiated lymphocytic lymphoma diagnosed in 1971. In 1980 pleural biopsy showed epithelial-type mesothelioma. He was stable on chemotherapy for 9 months except for an enlarging liver with two masses that a biopsy did not diagnose, and died 3 months later. He had used asbestos paper to make puppets in a college class. Neither man had an autopsy. Calling the exposure histories unconvincing, the authors still wrote that the mesotheliomas probably marked both men as having asbestos-caused cancers, adding to the presumption that the lymphoid cancers had the same cause. They called for a large-scale epidemiologic study.

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: case report (two patients)
• Who was studied: Two men treated in New York: a 75-year-old white man admitted to Elmhurst Hospital in August 1982, and a 61-year-old man referred to Mount Sinai Hospital in March 1980
• Exposure: Case 1: several months of clerical work in US Navy yards during World War II, with no other known asbestos exposure; the article does not establish actual asbestos contact there. Case 2: used asbestos paper to make puppets in a college class; he also served in US Navy yards 1942 to 1945 as a crew chief but was not aware of asbestos exposure there. Fiber type not stated.
• Main results:
  • Case 1 was first diagnosed (May 1982) with chronic lymphocytic leukemia by lymph node biopsy
  • In Case 1, a later bone marrow biopsy showed metastatic mesothelioma alongside lymphocytes, and pleural biopsy confirmed mesothelioma of fibrous sarcomatous type
  • Case 1 died within 1 month of admission from pulmonary infection; the mesothelioma was never treated
  • Case 2 had a diffuse, poorly differentiated lymphocytic lymphoma diagnosed in 1971, with later recurrences treated with radiotherapy and chemotherapy
  • In Case 2, open pleural biopsy in 1980 showed malignant mesothelioma, epithelial type
  • Case 2 remained stable on chemotherapy for 9 months except for an increase in liver size. A sonogram showed two liver masses, considered to be metastatic mesothelioma, but a needle biopsy of the liver was not diagnostic of either lymphoma or mesothelioma.
  • Case 2 then deteriorated and died 3 months later
  • No autopsy was performed in either case
• The authors' conclusion: The authors wrote that, despite unconvincing exposure histories, the presence of mesothelioma probably marked both patients as having asbestos-caused neoplasms, adding to the presumption that their lymphoid neoplasia was similarly caused. They called for a large-scale epidemiologic study to explore the relationship.
• Limitations the authors state:
  • The authors described the asbestos exposure histories as unconvincing
  • The co-occurrence of the two cancers may be coincidence
  • For Patient 2 only, radiation or chemotherapy for the first cancer may have increased the likelihood of the second

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Neoplasm, Pleural Mesothelioma, Asbestos Exposure.

Related studies

• Lymphocytic alveolitis and pleural calcifications in nonoccupational asbestos exposure. Protection against neoplasia? — S.H. Constantopoulos, Y.A. Dalavanga, et al. (1992)
• Asbestos and non-Hodgkin's lymphoma — (1983)
• Asbestos-associated neoplasms of B cell lineage — E. Kagan, R.J. Jacobson, et al. (1979)
• Lymphoid and plasma cell malignancies: asbestos-related disorders of long latency — E. Kagan, R.J. Jacobson (1983)
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• Application of markers in the diagnosis of soft tissue tumours — P.J. Roholl, A.S. De Jong, et al. (1985)

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