Diffuse pleural mesothelioma in Trieste. A survey based on autopsy cases

Our plain-English summary of Diffuse pleural mesothelioma in Trieste. A survey based on autopsy cases, by C. Bianchi, G. Grandi, L. Di Bonito (Tumori, 1978).

The study

• Authors: C. Bianchi, G. Grandi, L. Di Bonito
• Journal: Tumori
• Published: 1978;64(6):565-70
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Records of necropsies performed at the Institute of Pathological Anatomy and Histology of the University of Trieste during the period December 1 1971-December 31 1977 have been reviewed. Cases with a necropsy diagnosis of pleural tumor or lung sarcoma were reexamined. Twenty-six cases were accepted as definite diffuse pleural mesothelioma. Occupational history was indicative of asbestos exposure in 22 cases, with 12 patients having worked in shipyards. The high incidence of diffuse pleural mesothelioma in the Province of Trieste is emphasized.

In plain English

This study reviewed the records of 10,466 autopsies performed at the Institute of Pathological Anatomy and Histology of the University of Trieste, Italy, from December 1, 1971 to December 31, 1977. The authors re-examined the 39 cases with an autopsy diagnosis of pleural tumor or lung sarcoma and accepted 26 as definite diffuse pleural mesothelioma. Only 3 of the 26 were female, and ages ranged from 52 to 81 years. Relatives were interviewed about work history, which was obtained for 25 cases. Of these, 22 patients had been exposed to asbestos at work, 12 of them in shipyards. The time from first exposure to death ranged from 28 to 60 years (average 44). Asbestos bodies were found in the lungs of 20 patients. The 10 cases in men in 1977 corresponded to an age-standardized rate of 3.5 per 100,000 males. The authors concluded that incidence in the Province of Trieste seemed relatively high compared with other areas. They noted that their strict criteria probably excluded some true cases, so the true incidence was understated.

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 autopsy records (autopsy case series), with re-examination of histological sections, interviews with relatives about occupational history, and examination of lung sections for asbestos bodies
• Who was studied: Autopsy cases at the Institute of Pathological Anatomy and Histology, University of Trieste, Italy, December 1, 1971 to December 31, 1977. Of 10,466 autopsies, 39 had a diagnosis of pleural tumor or lung sarcoma, and 26 were accepted as definite diffuse pleural mesothelioma (23 male, 3 female, aged 52 to 81).
• Exposure: Occupational asbestos exposure, judged from occupational history obtained from relatives. Jobs included shipyard trades (laborers, welders, mechanics, carpenter, foundry worker), naval motor factory work, shipboard work, and petroleum refinery work. Duration of exposure was 2 to 43 years. Intensity was judged moderate in all 22 exposed cases. The article does not name the asbestos fiber types.
• Main results:
  • 39 autopsy cases had a diagnosis of pleural tumor or lung sarcoma. 3 mesotheliomas were excluded as localized, and in 10 the diagnosis of diffuse pleural mesothelioma was considered uncertain, leaving 26 definite cases.
  • Among the 26 definite cases, 3 were female. Ages ranged from 52 to 81 years, with 13 aged 60 to 69.
  • Smoking information was available for 23 of the 26 cases; 14 of these were reported to have been smokers.
  • A clinical (before-death) diagnosis of pleural mesothelioma had been made in 15 of the 26 cases.
  • Occupational history was obtained for 25 cases. 22 had been exposed to asbestos at work, 12 of them in shipyards.
  • Among the exposed cases, the interval from onset of exposure to death was 28 to 60 years (average 44).
  • Asbestos bodies were found in the lungs of 20 patients, abundant in 11 and rare in the others.
  • No asbestos bodies were found in 4 patients with a history of asbestos exposure. Several bodies were seen in 1 patient with a negative history (case 8), whom the authors considered could be regarded as exposed.
  • The 10 cases in males in 1977 corresponded to an age-standardized incidence rate of 3.5 per 100,000 males (standardized on world population) and a truncated rate of 7.5. The authors stated these values were higher than those found in any other country, citing published cancer incidence data.
  • Tumor patterns were pure epithelial in 5 cases, pure sarcomatous in 5, and mixed in 16. The left pleura was affected in 13 cases, the right in 12, and both sides in 1.
• The authors' conclusion: The authors concluded that, compared with data from other Italian regions and other countries, their results seemed to indicate a relatively high incidence of diffuse pleural mesothelioma in Trieste. They also noted a history of asbestos exposure in a high percentage of cases, a prevalence of men employed in shipbuilding, and a long latency.
• Limitations the authors state:
  • The strict diagnostic criteria probably excluded some true cases of mesothelioma.
  • The true incidence is understated because only autopsy cases with certain diagnoses were counted.
  • The method used to look for asbestos bodies in lung tissue was crude, which may explain negative findings in patients with a history of exposure.
  • Case numbers varied widely from year to year. The number of autopsies rose over the period, and attention to pleural tumors increased from 1977, when the Institute began participating in the Italian Mesothelioma Register.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Autopsy, Histology, Sarcoma, Occupational History, Asbestos Exposure.

Related studies

• Malignant mesothelioma of the pleura in Trieste, Italy — L. Giarelli, C. Bianchi, et al. (1992)
• Asbestos and tuberculosis in Trieste, Italy — A.M. Walker, G. Stanta, et al. (1985)
• An autopsy case of diffuse malignant mesothelioma of the pericardium — N. Sakuma, T. Kamei, et al. (1997)
• Asbestos exposure in the Monfalcone area. A social and pathological study of 100 autopsy cases — C. Bianchi, A. Brollo, et al. (1981)
• Asbestos exposure in malignant mesothelioma of the pleura: a survey of 557 cases — C. Bianchi, A. Brollo, et al. (2001)
• Coated and uncoated lung mineral fibres in subjects with and without pleural plaques at autopsy — A. Andrion, D. Bellis, et al. (1984)

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