Metastases in diffuse pleural mesothelioma: influence of histological type

Our plain-English summary of Metastases in diffuse pleural mesothelioma: influence of histological type, by M. Huncharek, J. Muscat (Thorax, 1987).

The study

• Authors: M. Huncharek, J. Muscat
• Journal: Thorax
• Published: 1987;42(11):897-8
• Cited by: 38 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004757).

Summary of the article

This short report examined how often diffuse pleural mesothelioma spreads to distant sites, and whether this depends on histological type. Earlier reports had stressed that metastases were infrequent, while some suggested that blood-borne spread was characteristic of the sarcomatous type. The authors reviewed 42 cases (40 men, two women) proved histologically after complete necropsy. A pathologist of the Canadian Tumor Reference Center confirmed each diagnosis. Medical records and necropsy and pathology reports were reviewed. Tumours were classed as epithelial, sarcomatous or mixed, and a chi-square analysis tested the relation between cell type and distant metastases. Median age was 62 years (range 45-80). Distant metastases were found at necropsy in 32 of the 42 cases (76%). The commonest sites were the contralateral lung (16 cases), kidney (11), liver (9) and adrenals (8). Regional lymph node metastases were found in 19 cases (45%). Thirty-eight subjects (90%) had documented occupational asbestos exposure (mean 20.9 years). One woman had domestic exposure, and histories were unavailable for three men. Metastases occurred in 75% of epithelial, 70% of sarcomatous and 83% of mixed tumours. There was no statistically significant association between histological type and metastases, or between histological type and age at diagnosis. The authors concluded that distant metastases are a common feature of diffuse pleural mesothelioma and that all three cell types are associated with metastatic spread.

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 short report described 42 people with diffuse pleural mesothelioma (40 men, two women). Each diagnosis was confirmed by a complete necropsy (autopsy) and by a pathologist at the Canadian Tumor Reference Center. The authors recorded where the cancer had spread and compared spread across the three tissue types: epithelial, sarcomatous and mixed. Thirty-eight people (90%) had documented occupational asbestos exposure and one woman had domestic exposure. Histories were not available for three men, and fiber types were not reported. The median age was 62. Distant metastases were found at necropsy in 32 of the 42 cases (76%), most often in the opposite lung (16 cases), kidney (11), liver (9) and adrenal glands (8). Regional lymph nodes were affected in 19 cases (45%). Metastases were found in 15 of 20 epithelial (75%), 7 of 10 sarcomatous (70%) and 10 of 12 mixed (83%) tumours. The link between tissue type and metastases was not statistically significant. The authors concluded that distant metastases are a common feature of diffuse pleural mesothelioma and that all three cell types are associated with metastatic spread.

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 of necropsy-confirmed cases, reviewing medical records, necropsy and pathology reports; chi-square analysis of cell type versus distant metastases
• Who was studied: 42 cases of diffuse pleural mesothelioma (40 men, two women), confirmed histologically after complete necropsy and reviewed by a pathologist of the Canadian Tumor Reference Center, Ottawa; years of the cases not stated
• Exposure: Asbestos exposure history: 38 subjects (90%; 37 men, one woman) had documented occupational exposure, lasting from 1 month to 46 years; one woman had domestic exposure; histories were unavailable for three men. Fiber types and jobs were not reported.
• Main results:
  • Distant metastases were found at necropsy in 32 of the 42 cases (76%)
  • Most common metastatic sites: contralateral lung (16 cases) and kidney (11 cases, bilateral in 6)
  • Other common sites: liver (9 cases) and adrenals (8 cases, bilateral in 3)
  • Regional lymph node metastases were found in 19 of the 42 cases (45%)
  • Epithelial tumours: 15 of 20 (75%) had metastases
  • Sarcomatous tumours: 7 of 10 (70%) had metastases
  • Mixed tumours: 10 of 12 (83%) had metastases
  • No statistically significant association between histological type and presence of metastases, or between histological type and age at diagnosis
  • Median age was 62 years (range 45-80); primary tumour was in the left pleura in 17 patients (40%), right pleura in 23 (55%), and bilateral in 2 (5%)
  • Among the 38 with occupational exposure, mean exposure duration was 20.9 years (printed as "20-9"; range 1 month to 46 years)
• The authors' conclusion: The authors concluded that distant metastases are a common feature of diffuse pleural mesothelioma and that all three cell types are associated with metastatic spread

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Autopsy, Pathology Report, Asbestos Exposure.

Related studies

• Distant visceral metastases in pleural mesothelioma — G.H. Roberts (1976)
• Occupational exposures and risk of oesophageal cancer by histological type: a case-control study in eastern Spain — M. Santibañez, J. Vioque, et al. (2008)
• Diffuse mesothelioma of the peritoneum: correlation between histological and clinical parameters and survival in 73 patients — S. Liu, P. Staats, et al. (2014)
• A study of the histological cell types of lung cancer in workers suffering from asbestosis in the United Kingdom — F. Whitwell, M.L. Newhouse, et al. (1974)
• Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour — M.R. Law, M.E. Hodson, et al. (1982)
• Occupational exposures and risk of stomach cancer by histological type — M. Santibañez, J. Alguacil, et al. (2012)

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