Histopathology of the pleura

Our plain-English summary of Histopathology of the pleura, by B. Corrin, B.J. Addis (Respiration; International Review of Thoracic Diseases, 1990).

The study

• Authors: B. Corrin, B.J. Addis
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 1990;57(3):160-75
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This review attempts to provide up to date information on structure/function relationships of the pleura and on the pathology of pleural effusions, pneumothorax, pleural repair, pleural infections, pleural involvement in systemic connective tissue disorders, non-malignant asbestos-induced pleural disease, mesothelioma and other pleural tumours.

In plain English

This was a review article by authors at the Brompton Hospital, London. It did not report a new study. It summarized published work on the pleura (the lining of the lungs and chest wall): its structure, effusions, pneumothorax, infections, connective tissue disorders, non-malignant asbestos-related pleural disease, mesothelioma and other pleural tumours. It described six asbestos fiber types. The authors wrote that the South African data incriminated crocidolite as a cause of mesothelioma, while chrysotile alone was of doubtful significance, a picture complicated by amphibole contamination, particularly tremolite. They reported that the interval between asbestos exposure and mesothelioma is generally 20 to 40 years, with a minimum of about 14 years. They stated that pleural plaques rarely develop within 15 years of first exposure, that most appear after 30 years, and that plaques are harmless. They noted that few mesothelioma patients survive longer than 2 years from diagnosis. They cautioned that lung fiber counts vary between laboratories.

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: Narrative review of published literature on pleural histopathology (no original study population)
• Who was studied: No population of its own; the review drew on previously published studies and case series cited in its reference list
• Exposure: Asbestos, described as six fibrous silicates: chrysotile, crocidolite, amosite, anthophyllite, tremolite and actinolite; erionite and other fibres were also discussed
• Main results:
  • The authors stated that the original South African data incriminated crocidolite as a cause of mesothelioma
  • The authors wrote that chrysotile alone is of doubtful significance in causing mesothelioma, noting that epidemiological studies are complicated by contamination of chrysotile with amphiboles, particularly tremolite
  • Citing other work, the authors reported that the minimum latent period for mesothelioma is about 14 years, with the interval generally between 20 and 40 years
  • The authors stated that about 10% of all mesotheliomas appear to be unrelated to mineral fibre exposure
  • Citing another study, the authors reported that in one asbestos manufacturing company the ratio of peritoneal to pleural mesotheliomas fell from 5:1 before 1921 to 1:3 after 1950
  • The authors wrote that the level of asbestos exposure necessary to cause mesothelioma is far less than that required to cause asbestosis
  • The authors stated that very few pleural plaques develop within 15 years of first exposure and most appear after 30 years
  • The authors stated that pleural plaques are harmless and have no other relationship to mesothelioma
  • The authors wrote that benign asbestos pleurisy may develop within 10 years of first contact with asbestos, and that asbestos-induced pleurisy is thought to play no part in the development of pleural mesothelioma
  • Citing other series, the authors reported that epithelial, fibrous and mixed mesotheliomas made up 67, 7 and 26 percent at the Mount Sinai Hospital, New York, and 52, 22 and 26 percent at the Brompton Hospital, London
  • The authors stated that progression of mesothelioma is not appreciably modified by treatment and few patients survive longer than 2 years from diagnosis
  • The authors wrote that localised fibrous tumour of the pleura differs from diffuse mesothelioma in being localised, unrelated to asbestos exposure and having a much better prognosis
  • The authors wrote that calling an otherwise typical mesothelioma in an asbestos worker by a name such as osteosarcoma of the pleura is inappropriate and may prejudice a justifiable claim for industrial compensation
• The authors' conclusion: As a narrative review, the article did not state a single overall conclusion
• Limitations the authors state:
  • The authors noted that lung asbestos fibre counts vary between laboratories and that their table of counts provides only a general guide

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Histopathology, Pleura, Pathology, Pleural Effusion, Pneumothorax, Mesothelioma.

Related studies

• 'Black Spots' and hyaline pleural plaques on the parietal pleura of 150 urban necropsy cases — K. Mitchev, P. Dumortier, et al. (2002)
• Imaging of the pleura — E.J. Helm, T.N. Matin, et al. (2010)
• The pleura in health and disease — R. Murali, K. Park, et al. (2010)
• Imaging of the pleura — N.L. Müller (1993)
• Asbestos and the pleura: a review — D.W. Cugell, D.W. Kamp (2004)
• Costal pleura: appearances at high-resolution CT — J.G. Im, W.R. Webb, et al. (1989)

Browse more research in Respiration; International Review of Thoracic Diseases, or return to medical research.