Mesotheliomas and secondary tumors of the pleura

Our plain-English summary of Mesotheliomas and secondary tumors of the pleura, by K. Ellis, M. Wolff (Seminars in Roentgenology, 1977).

The study

• Authors: K. Ellis, M. Wolff
• Journal: Seminars in Roentgenology
• Published: 1977;12(4):303-11
• Cited by: 27 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This review, by a radiologist and a surgical pathologist at Columbia University, set out current concepts about primary pleural tumors (the mesotheliomas) and the more common secondary tumors of the pleura. It was illustrated with chest roentgenograms and histologic images from individual patients.

Localized fibrous mesotheliomas were described as rare, slow-growing and usually pedunculated. More than 75% arose from the visceral pleura. They were often found on routine chest films in adults mainly aged 45-65. No special association with asbestos exposure had been evident. Extrathoracic features such as osteoarthropathy and hypoglycemia were described. Surgical excision was curative in most patients, with recurrence in about 20%.

Diffuse mesotheliomas were described as of increasing interest because of their relationship to asbestos exposure. They had three radiologic presentations and occurred in men about five times as often as in women, nearly all over 40. A definite history of asbestos exposure was obtained in 10%-40% or more of patients. The authors discussed difficulties in telling the tumor apart from reactive mesothelium, fibrous pleural scar and metastatic carcinoma, and the role of histochemical stains and electron microscopy. Treatment was generally unsatisfactory, and most patients died within a year of diagnosis.

Metastatic neoplasm was described as the most common pleural neoplasm, and adenocarcinoma as the most common metastatic tumor producing pleural effusion. The authors stated that primary pleural neoplasms must be considered in all cases of persistent unexplained pleural effusion and of peripheral lung masses.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This 1977 article by a radiologist and a pathologist at Columbia University reviewed primary pleural tumors (mesotheliomas) and secondary tumors reaching the pleura. It used X-rays and tissue images from individual patients and reported no new study of a defined group. The authors described localized fibrous mesothelioma as rare. More than 75% arose from the visceral pleura, patients were mainly aged 45 to 65, and no special association with asbestos exposure had been evident. Surgery cured most patients, and the tumor recurred in about 20% of cases. Diffuse mesothelioma was described as of increasing interest because of its relationship to asbestos exposure. It was more common in men, at a ratio of about 5 to 1. A definite asbestos exposure history was obtained in 10% to 40% or more of patients, depending on the population and the adequacy of the historical data. Most died within a year of diagnosis. The authors stressed that separating diffuse mesothelioma from metastatic cancer was difficult, and that diagnosis was not always conclusive. The article did not name asbestos fiber types.

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 primary pleural mesotheliomas (localized fibrous and diffuse) and secondary pleural tumors, illustrated with radiographs and pathology images of individual patients
• Who was studied: No defined study group. The review draws on published literature, and its figures show individual patients, for example a dyspneic 65-year-old ship's painter with diffuse papillary and tubular pleural mesothelioma.
• Exposure: Asbestos exposure is discussed in relation to diffuse pleural mesothelioma. No fiber types, products or doses are specified.
• Main results:
  • Localized fibrous mesotheliomas: more than 75% arise from the visceral pleura
  • Localized fibrous mesotheliomas: patients are mainly aged 45 to 65
  • Localized fibrous mesotheliomas: no special association with asbestos exposure has been evident
  • Localized fibrous mesotheliomas: surgical excision is curative in the majority of patients, and recurrence is seen in about 20% of cases
  • Diffuse mesothelioma: more common in men, at a ratio of about 5 to 1
  • Diffuse mesothelioma: a definite history of asbestos exposure is obtained in 10% to 40% or more of patients (printed as 'IO%-40%' in the OCR text), depending on the population involved and the adequacy of the historical data
  • Diffuse mesothelioma with asbestos exposure: ferruginous bodies are found in the underlying lung but not in the tumor tissue itself
  • Focally calcified pleural plaques due to asbestosis support the possibility of mesothelioma
  • Diffuse mesothelioma: in the majority of patients, death occurs within a year after diagnosis
  • Metastatic neoplasm is the most common neoplasm of the pleura
• The authors' conclusion: The authors concluded that optimal diagnosis of mesothelioma may require combining clinical, radiologic, histologic, histochemical and ultrastructural information, and that even then the diagnosis is not always conclusive

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, Visceral Pleura, Chest X-Ray, Asbestos Exposure, Mesothelium, Carcinoma, Neoplasm.

Related studies

• Massive bilateral upper lobe fibrosis secondary to asbestos exposure — R.A. Green, D.G. Dimcheff (1974)
• Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases — R. Shibata, T. Ozaki, et al. (2020)
• A case of giant benign localized fibrous tumor of the pleura — M. Biçer, S. Yaldiz, et al. (1998)
• Benign tumors of the liver — K.G. Ishak, L. Rabin (1975)
• Asbestos exposure and multiple primary tumors — V.A. Dohner, R.G. Beegle, et al. (1975)
• Asbestos and the pleura: a review — D.W. Cugell, D.W. Kamp (2004)

Browse more research in Seminars in Roentgenology, or return to medical research.