Malignant mesothelioma of the pleura in nonagenarian patients

Our plain-English summary of Malignant mesothelioma of the pleura in nonagenarian patients, by C. Bianchi, T. Bianchi, S. Bucconi (Tumori, 2011).

The study

• Authors: C. Bianchi, T. Bianchi, S. Bucconi
• Journal: Tumori
• Published: 2011;97(2):156-9
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aims And Background: Malignant mesothelioma developing at very old ages is a rare event. The reasons for such late development were investigated.

Methods: A series of 811 malignant mesothelioma of the pleura, diagnosed at the Trieste and Monfalcone Hospitals, in northeastern Italy, in the period 1968-2008 were reviewed. Eight cases regarding patients aged 90 years or more were selected. In such cases, occupational histories were re-examined, and additional data could be obtained from the patients' relatives. Routine lung sections obtained at necropsy were examined for asbestos bodies. In 2 cases, asbestos bodies had been isolated after chemical digestion of lung tissue.

Results: The group included 7 men and one woman, aged between 90 and 93 years. All 8 patients had long-term histories of occupational exposure to asbestos, mostly in shipyards. Latency periods, elapsed between first exposure to asbestos and tumor manifestation, ranged between 64 and 75 years. Asbestos bodies were found on routine lung sections in 6 cases. Isolation of lung asbestos bodies showed 72,000 bodies per gram of dried tissue in a 90-year-old man, who had worked in the shipyards for 34 years, and 150 bodies per gram in a 93-year-old woman, who had worked in the shipyards for 23 years.

Conclusions: In this group of cases, the late development of mesothelioma can not be attributed to mild exposure to asbestos or to unusually late exposures. Very long latency periods even in people heavily exposed suggest an individual resistance to the oncogenic effects of asbestos.

In plain English

The authors reviewed 811 cases of malignant mesothelioma of the pleura (the lining around the lungs) diagnosed at hospitals in Trieste and Monfalcone, northeastern Italy, from 1968 to 2008. They re-examined in detail the 8 patients aged 90 or older: 7 men and one woman, aged 90 to 93. Autopsy findings were available for all 8. All had long-term histories of work-related asbestos exposure, and 6 had worked in shipyards. Exposure lasted over 20 years in at least 5 cases. Where it could be calculated (6 cases), the time from first exposure to diagnosis ranged from 64 to about 75 years. Asbestos bodies were seen on routine lung slides in 6 cases. Counts were done in two cases. They found 72,000 asbestos bodies per gram of dried lung tissue in a 90-year-old man who had worked 34 years in shipyards, and 150 per gram in a 93-year-old woman who had worked 23 years in shipyards. The authors noted that these counts only partly reflect actual exposure. The authors concluded that the late onset could not be explained by mild or late exposure, and suggested individual resistance to the cancer-causing effects of asbestos.

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: from a hospital series of 811 pleural mesotheliomas, the cases in people aged 90 or older were re-examined in detail (autopsy findings, occupational histories, asbestos bodies in lung tissue)
• Who was studied: 8 patients aged 90 to 93 (7 men, 1 woman) with malignant pleural mesothelioma, selected from 811 pleural mesotheliomas diagnosed at the Trieste and Monfalcone hospitals, northeastern Italy, 1968-2008; autopsy findings available for all 8
• Exposure: Occupational asbestos exposure, mostly in shipyards (trades included shipwright, caulker, cleaner and welder), with some seafaring work. First exposure was between 1915 and 1941 according to the table. The article does not report which asbestos fiber types these patients were exposed to; the authors suggested, based on an earlier study of Monfalcone shipyard workers, that they had plausibly been exposed to different varieties.
• Main results:
  • Of the 8 patients, 6 had worked in shipyards; cases 1 and 4 had worked in the maritime branch (seafarers)
  • Duration of asbestos exposure was over 20 years in at least 5 of the 8 cases
  • Latency (first exposure to diagnosis), calculated in 6 cases, ranged from 64 to about 75 years
  • Asbestos bodies were seen on routine lung sections in 6 of the 8 cases
  • In the two cases where lung asbestos bodies were counted, there were 72,000 bodies per gram of dried tissue in a 90-year-old man with 34 years in shipyards, and 150 per gram in a 93-year-old woman with 23 years in shipyards
• The authors' conclusion: The authors concluded that in this group the late development of mesothelioma could not be attributed to mild or unusually late exposure, and that very long latency periods even in heavily exposed people suggest an individual resistance to the oncogenic (cancer-causing) effects of asbestos
• Limitations the authors state:
  • Because asbestos fibers are cleared from the lungs over time (31 and 41 years had passed since exposure ended in the two counted cases), the lung asbestos body counts reflect only partly the patients' actual exposure
  • Precise timing details of exposure were not available for case 7

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, Pleura, Autopsy, Asbestos Bodies, Occupational Exposure, Latency.

Related studies

• Malignant mesothelioma of the pleura in Trieste, Italy — L. Giarelli, C. Bianchi, et al. (1992)
• Asbestos exposure in malignant mesothelioma of the pleura: a survey of 557 cases — C. Bianchi, A. Brollo, et al. (2001)
• Familial mesothelioma of the pleura--a report of 40 cases — C. Bianchi, A. Brollo, et al. (2004)
• Malignant mesothelioma of the pleura and other malignancies in the same patient — C. Bianchi, T. Bianchi, et al. (2007)
• Pseudomesotheliomatous carcinoma of the pleura: an autopsy case of metastasis from a G-CSF-producing anaplastic carcinoma of the pancreas — Y. Hattori, K. Sentani, et al. (2018)
• Pleural plaques as risk indicators for malignant pleural mesothelioma: a necropsy-based study — C. Bianchi, A. Brollo, et al. (1997)

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