Malignant peritoneal mesothelioma: quantitative analysis of asbestos burden

Our plain-English summary of Malignant peritoneal mesothelioma: quantitative analysis of asbestos burden, by R. Kurimoto, T. Kishimoto, Y. Nagai, et al (Pathology International, 2009).

The study

• Authors: R. Kurimoto, T. Kishimoto, Y. Nagai, H. Takazawa, N. Sakaue, Y. Shinohara, K. Hiroshima
• Journal: Pathology International
• Published: 2009;59(11):823-7
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesotheliomas develop commonly in the pleural cavity and rarely arise in the peritoneal cavity. It is well established that asbestos exposure is related to malignant pleural mesothelioma, but the asbestos burden in the abdominal cavity in patients with malignant peritoneal mesothelioma has not been well studied. The purpose of the present study was therefore to report on an autopsy case of malignant peritoneal mesothelioma with quantitative analysis of the asbestos burden in tissues from the pleura and organs in the abdominal cavity. The patient was a 67-year-old man with a history of asbestos exposure. The peritoneum was thickened with diffuse tumor proliferation. This patient was diagnosed as having malignant peritoneal epithelioid mesothelioma. The number of asbestos fibers was >10,000/g dry tissue in all samples examined except in the small intestine. The number of asbestos fibers in the stomach was 53,000/g, which was higher than that in a control asbestosis subject. The existence of numerous asbestos fibers found in the abdominal cavity suggests that asbestos stimuli are related to the tumorigenesis of malignant peritoneal mesothelioma.

In plain English

This was a case report from Japan on the autopsy of a 67-year-old man with malignant peritoneal mesothelioma. He had been exposed to asbestos in a quarry for 6 years in his youth and died 12 months after admission. The epithelioid-type tumor had spread widely over the peritoneum, and pleural plaques were present. The authors counted asbestos fibers and asbestos bodies (coated fibers) in his tissues and compared them with those of an 82-year-old man with severe asbestosis. In the patient, fiber counts exceeded 10,000 per gram of dry tissue in all samples except those from the small intestine, in which none were found. The highest count was in the stomach, at 53,000 per gram. His lung held 56,000 asbestos bodies per gram, and none were found elsewhere. Lung fibers were amosite (75%) and tremolite (25%). The asbestosis subject had fewer fibers in the stomach (360 per gram) and diaphragm (210 per gram). The authors suggested that abdominal fiber accumulation is associated with peritoneal mesothelioma. They noted that their microscopy could not rule out fibers elsewhere, and that sampling error may explain the small intestine finding.

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 (single autopsy case), with a fiber burden comparison against one autopsy subject with asbestosis
• Who was studied: one 67-year-old man in Chiba, Japan, admitted in September 2004 and autopsied after his death 12 months later; comparison tissues came from an 82-year-old man with asbestosis and a history of asbestos exposure
• Exposure: asbestos exposure in a quarry for 6 years in his youth; fibers typed in lung tissue by transmission electron microscopy were amosite (75%) and tremolite (25%)
• Main results:
  • In the mesothelioma patient, asbestos fiber counts were above 10,000 per gram of dry tissue in all samples except the small intestine, where no fibers were found in the samples examined
  • The highest fiber count in the mesothelioma patient was in the stomach, at 53,000 per gram of dry tissue
  • The mesothelioma patient had 56,000 asbestos bodies per gram of dry lung tissue, and asbestos bodies were found only in the lung
  • Lung fibers in the mesothelioma patient were amosite (75%) and tremolite (25%), and no other asbestos types were seen
  • In the asbestosis subject, fiber counts per gram of dried tissue were 360 in the stomach and 210 in the diaphragm, lower than the mesothelioma patient's 53,000 and 13,000 at those sites
  • The asbestosis subject's mesenteric lymph node had 260 fibers and 130 asbestos bodies per gram of dried tissue; Table 2 reports no data for the mesothelioma patient's mesenteric lymph node
  • The tumor was diagnosed as malignant peritoneal mesothelioma, epithelioid type
  • Chest imaging of the mesothelioma patient showed bilateral pleural plaques
• The authors' conclusion: The authors suggested that the accumulation of asbestos fibers in the abdominal cavity is associated with the development of malignant peritoneal mesothelioma. They also suggested that the high stomach count meant the patient may have swallowed a considerable amount of asbestos.
• Limitations the authors state:
  • The presence of asbestos fibers in other sites could not be ruled out because the sensitivity of microscopy was not adequate
  • Sampling error must be considered in explaining why no asbestos was found in the small intestine
  • The precise route by which asbestos reached the peritoneum could not be determined

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: Peritoneal Mesothelioma, Malignant Mesothelioma, Pleural Cavity, Peritoneal Cavity, Asbestos Exposure, Pleural Mesothelioma, Autopsy, Pleura.

Related studies

• Quantitative analysis of asbestos burden in women with mesothelioma — R.F. Dodson, M. O'Sullivan, et al. (2003)
• Quantitative analysis of asbestos burden in a series of individuals with lung cancer and a history of exposure to asbestos — R.F. Dodson, D.R. Brooks, et al. (2004)
• A trial on the quantitative risk assessment of man-made mineral fibers by the rat intraperitoneal administration assay using the JFM standard fibrous samples — S. Adachi, K. Kawamura, et al. (2001)
• Asbestos textile production linked to malignant peritoneal and pleural mesothelioma in women: Analysis of 28 cases in Southeast China — Z. Gao, K. Hiroshima, et al. (2015)
• Evaluation of the exposure, dose-response and fate in the lung and pleura of chrysotile-containing brake dust compared to TiO2, chrysotile, crocidolite or amosite asbestos in a 90-day quantitative inhalation toxicology study - Interim results Part 1: Experimental design, aerosol exposure, lung burdens and BAL — D.M. Bernstein, B. Toth, et al. (2020)
• Epidemiological and quantitative relationships between mesothelioma and asbestos on Tyneside — T. Ashcroft (1973)

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