Histological characteristics of mesothelioma associated with asbestos

Our plain-English summary of Histological characteristics of mesothelioma associated with asbestos, by J. Churg, S.H. Rosen, S. Moolten (Annals of the New York Academy of Sciences, 1965).

The study

• Authors: J. Churg, S.H. Rosen, S. Moolten
• Journal: Annals of the New York Academy of Sciences
• Published: 1965;132(1):614-22
• Cited by: 92 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. 001518).

Abstract

Cytological and histological features in 30 cases of mesothelioma associated with asbestos exposure are presented. All cases conform to the gross and microscopic criteria for this type of tumor. There were 13 pleural and 17 peritoneal cases. The cytological and histological features were identical in both types. Two variants of tumor cells were seen; epithelium-like and mesenchymal. Epithelium-like cells were found in all 30 cases. In nine of these mesenchymal tumor elements were also present. Several histological patterns could be recognized : papillary, tubular, tubulopapillary, solid, nodular, and sheet-like. In the majority of cases several patterns coexisted. Demonstration of acid mucopolysaccharides in association with epithelium-like cells was of diagnostic value.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This 1965 pathology study described the microscopic features of 30 mesotheliomas associated with asbestos exposure. The authors counted a case as asbestos-associated when lung tissue showed asbestosis together with asbestos bodies. The article does not name fiber types. Eleven cases were in asbestos insulation workers, 10 of them found among 307 consecutive deaths. Seven came from 26 consecutive asbestosis cases among 2500 autopsies at Middlesex General and Barnert Memorial Hospitals. Twelve came from 45 Armed Forces Institute of Pathology cases checked for asbestos bodies. Thirteen tumors were pleural and 17 peritoneal. Twenty-two patients had known exposure or a considerable number of asbestos bodies; eight had no known exposure and few asbestos bodies. Epithelium-like tumor cells appeared in all 30 cases, with mesenchymal tumor elements also present in nine. Most tumors showed several patterns. None of about 20 cases tested contained epithelial mucus, and acid mucopolysaccharides were found only in some. The authors concluded that finding acid mucopolysaccharides alongside epithelium-like cells was of diagnostic value. They noted that their tissue was fixed only in formalin and that seven cases had only biopsy material, where diagnosis is only tentative.

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 series (pathology study) describing the microscopic and histochemical features of mesotheliomas associated with asbestos exposure
• Who was studied: 30 cases of mesothelioma studied over two years. Eleven were in asbestos insulation workers: 10 found among 307 consecutive deaths in a large group of these workers, and one in a man still alive. Seven came from 26 consecutive asbestosis cases among 2500 autopsies at Middlesex General Hospital and Barnert Memorial Hospital. Twelve came from a review of Armed Forces Institute of Pathology (AFIP) files. Twenty-three came to autopsy; seven had only biopsy material.
• Exposure: Asbestos exposure, established in each case by finding asbestosis (diffuse interstitial pulmonary fibrosis) together with asbestos bodies in the lung. No fiber types are named. Twenty-two cases had known exposure or a considerable number of asbestos bodies; eight had no known exposure and only a small number of asbestos bodies.
• Main results:
  • Of the 30 cases, 13 were pleural and 17 were peritoneal mesotheliomas. The authors called this frequency of peritoneal tumors noteworthy.
  • Of the 30 cases, 22 had known asbestos exposure or a considerable number of asbestos bodies in the lungs.
  • The remaining 8 of the 30 cases had no known asbestos exposure and only a small number of asbestos bodies in the lungs.
  • Seven of the 30 cases came from a series of 26 consecutive asbestosis cases among 2500 autopsies at two of the authors' institutions.
  • In the AFIP review, 45 diffuse pleural and peritoneal mesotheliomas with lung tissue available were examined for asbestos bodies; asbestos bodies were found in 12.
  • Epithelium-like tumor cells were found in all 30 cases. Mesenchymal tumor elements were also present in 9 of them (Table 1: biphasic 9, epithelial 21).
  • The authors recognized several histological patterns (papillary, tubular, tubulopapillary, solid, nodular and sheet-like). In most cases several patterns occurred together.
  • Pleural and peritoneal mesotheliomas showed only small differences, mainly in how often certain histological patterns occurred. In their summary the authors described the features as identical in both types.
  • Tumor cells were generally regular. Pleomorphism, anaplasia and atypical mitoses were rare.
  • Of about 20 cases tested, none contained epithelial mucus. Acid mucopolysaccharides were demonstrated in only some cases.
• The authors' conclusion: The authors concluded that all 30 cases met the gross and microscopic criteria for mesothelioma. They also concluded that showing acid mucopolysaccharides together with epithelium-like cells was of diagnostic value.
• Limitations the authors state:
  • Special fixation (for example in alcohol-containing mixtures) is needed to preserve acid mucopolysaccharides, which dissolve in water, but the authors' material was fixed only in formalin.
  • Diagnosis from biopsy material alone is only tentative; such cases should be classified as probable mesothelioma. Seven of the 30 cases had only biopsy material.
  • The frequency of anaplasia is difficult to determine, because cases with considerable dedifferentiation are often classified as carcinoma rather than mesothelioma.
  • It was difficult to tell whether areas of hyalinized, cell-free connective tissue were part of the tumor or remnants of hyaline serosal plaques.

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: Mesothelioma, Asbestos Exposure, Epithelium, Mesenchymal Tumor, Tubulopapillary.

Related studies

• Surface characteristics of asbestos fibers released from asbestos- cement products — J.A. Helsen, P. van de Velde, et al. (1989)
• Radiological characteristics, histological features and clinical outcomes of lung cancer patients with coexistent idiopathic pulmonary fibrosis — K.A. Khan, M.P. Kennedy, et al. (2015)
• The Association between the Histological Subtypes of Mesothelioma and Asbestos Exposure Characteristics — T. Vorster, J. Mthombeni, et al. (2022)
• A histochemical study of the asbestos body coating — M. Governa, C. Rosanda (1972)
• The recovery and characterization of acid glycosaminoglycans in normal human urine. Influence of a circadian rhythm — J.E. Scott, D.J. Newton (1975)
• Glycosaminoglycans from two human malignant mesothelioma cell lines: determination, distribution, and effect of platelet-derived growth factor on their synthesis — G.N. Tzanakakis, N.K. Karamanos, et al. (1995)

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