Familial clustering of malignant mesothelioma

Our plain-English summary of Familial clustering of malignant mesothelioma, by B. Risberg, J. Nickels, J. Wågermark (Cancer, 1980).

The study

• Authors: B. Risberg, J. Nickels, J. Wågermark
• Journal: Cancer
• Published: 1980;45(9):2422-7
• Type of article: Case report
• Cited by: 54 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. 002049).

Abstract

A family with a remarkable aggregation of malignant mesothelioma is described. The father, 3 brothers, and a sister all died of the condition. The family and epidemiologic histories are reviewed. Random occupational asbestos exposure in the building industry probably occurred in 4 of the 5 cases. All of the patients were smokers. There is a low incidence of malignant mesothelioma in the area where they resided. These observations suggest that over and above the smoking and asbestos exposure, heredity may be an important predisposing factor in the genesis of this tumor.

In plain English

This case report described one family in which five members died of malignant mesothelioma: the father, three sons and a daughter. The authors re-examined records and tissue and asked relatives for work and smoking histories. The father and two sons had peritoneal mesothelioma, in the abdominal lining. The daughter had a tumor of the chest lining (pleura). The youngest son's tumor, at the top of the right lung, had spread to many organs; the authors said his diagnosis might be controversial. The father's diagnosis rested on re-examined biopsy material, since no autopsy was done. The father and three sons had worked in the building trade, where, the authors said, random asbestos exposure is known to occur. The daughter's husband had held various jobs, but it was not known whether he had been exposed to asbestos. All five smoked. No asbestos bodies were seen in lung sections from the three autopsied sons. Qualitative chemical analysis of lung tissue from two of them was consistent with asbestos. The authors suggested that smoking, asbestos exposure and genetic factors together may explain this family's cases.

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 of one family (five cases)
• Who was studied: A father, three sons (born 1915, 1917 and 1926) and a daughter (born 1923). All grew up in the same district. For the past 30 years they had lived in a town of about 100,000 inhabitants with no asbestos industry nearby. The authors worked at pathology departments in Linköping and Norrköping, Sweden, and Helsinki, Finland.
• Exposure: Probable random occupational asbestos exposure in the building trade for the father and three sons. No fiber type is named. The daughter worked as a shop assistant and in engineering and chocolate factories. Her husband had various occupations, and it was not known whether he had been exposed to asbestos. All five were cigarette smokers.
• Main results:
  • Father (Case 1): no autopsy was done. The authors re-examined biopsy material from a groin and abdominal tumor and interpreted it as malignant peritoneal mesothelioma.
  • Sons in Cases 2 and 3: peritoneal tubulopapillary mesothelioma, later spreading to the right pleura. The tumor in Case 3 had the same structure as in Case 2.
  • Daughter (Case 4): the pleura was thickened and nodular, and the diagnosis was tubulopapillary mesothelioma. No autopsy was done.
  • Youngest son (Case 5): a tumor at the apex of the right lung, with thickened right pleura and metastases to many organs. The tissue was strikingly similar to Cases 2 and 3.
  • The authors concluded that the four children died of malignant mesothelioma.
  • No asbestos bodies or lung fibrosis were seen in lung sections from the three autopsied sons (Cases 2, 3 and 5).
  • Qualitative chemical analysis of lung tissue from Cases 2 and 3 was consistent with asbestos. The elements found in Case 5 differed slightly.
  • All five patients had been cigarette smokers.
• The authors' conclusion: The authors suggested that the interplay of smoking, asbestos exposure and genetic factors may explain the high occurrence of malignant mesothelioma in this family.
• Limitations the authors state:
  • Information on the father's case was incomplete. No autopsy was performed.
  • The diagnosis in Case 5 might be controversial because the tumor had spread to many organs.
  • The chemical analysis of lung tissue could only be qualitative.
  • Asbestos fibres are commonly found in the lungs of the general population, so finding them does not by itself show occupational exposure.
  • The sample from Case 5 came from tissue next to the tumor rather than from the lung bases, which may explain why no asbestos was found.
  • Too little was known about the daughter's husband's work history, so household exposure could not be ruled out.

Topics

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

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

Related studies

• Familial pleural malignant mesothelioma: clustering in three sisters and one cousin — V. Ascoli, C.C. Scalzo, et al. (1998)
• Familial mesothelioma: a report of two families — S.P. Hammar, D. Bockus, et al. (1989)
• A cluster of familial malignant mesothelioma with del(9p) as the sole chromosomal anomaly — M. Musti, D. Cavone, et al. (2002)
• Well-differentiated papillary mesothelioma: clustering in a Portuguese family with a germline BAP1 mutation — C. Ribeiro, S. Campelos, et al. (2013)
• Familial mesothelioma: review and family study — H.T. Lynch, D. Katz, et al. (1985)
• DNA copy number changes in familial malignant mesothelioma — V. Ascoli, Y. Aalto, et al. (2001)

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