Primary pleural mesotheliomas in south India: a 25-year study

Our plain-English summary of Primary pleural mesotheliomas in south India: a 25-year study, by U. Kini, S. Shariff, J.A. Thomas (Journal of Surgical Oncology, 1992).

The study

• Authors: U. Kini, S. Shariff, J.A. Thomas
• Journal: Journal of Surgical Oncology
• Published: 1992;49(3):196-201
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In this report from South India, 15 patients with primary pleural mesothelioma have been diagnosed in the 25-year period 1, April 1966 through 31, March 1991, representing 0.02% of 76,239 biopsies received. The patients were mainly male with a mean age of 46.5 years. All except two had lived in urban Bangalore. None had been exposed to asbestos. The presentation clinically was peculiar, being continuous pricking pain, breathlessness, and cough with sputum. Physical and roentgenogram examination showed massive pleural effusion with irregular pleural thickening. Thoracotomy findings showed a distinct sessile nodularity with many slit-like spaces. Histologically, 14 were epithelial type mesotheliomas and 1 was a sarcomatous type. While the epithelial type neoplasms showed patchy squamoid differentiation, all showed mucin production. The CEA was always observed in areas of moderate differentiation. Spread occurred centrifugally to local structures on the same side as the lesion.

In plain English

This study reviewed the pathology archives and medical records of St. John’s Medical College in Bangalore, India, for patients diagnosed with primary pleural mesothelioma (cancer of the lining around the lung) between April 1966 and March 1991. Of 76,239 surgical biopsies, 234 came from the pleura, and 15 were diagnosed as primary pleural mesothelioma. That is 0.02% of all biopsies and 6.4% of pleural biopsies. Patients were aged 29 to 65 (mean 46.5 years), and all but three were male. The authors reported that none had had any contact with asbestos, and no asbestos bodies or ferruginous bodies were found in the tissue. Fourteen of the 15 had chest pain, and all had massive pleural effusion (fluid around the lung). All had first been treated for tuberculosis elsewhere. Fourteen tumours were epithelial type and one was sarcomatous type. Nine of 12 tumours tested showed the marker CEA. Only relatives of three patients answered follow-up requests, and two of those patients had died within 6 months of diagnosis. The authors concluded that this series showed no association with 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: Retrospective review (case series) of 25 years of pathology archive specimens and medical records at one Indian medical college, with re-examination of tissue and additional stains
• Who was studied: 15 patients diagnosed with primary pleural mesothelioma among 234 pleural specimens and 76,239 surgical biopsies, St. John’s Medical College, Bangalore, South India, 1 April 1966 to 31 March 1991. All were referrals to this tertiary centre.
• Exposure: The authors report that none of the 15 patients had had any contact with asbestos. No asbestos fibre types or occupations are described.
• Main results:
  • Primary pleural mesothelioma made up 0.02% of all 76,239 biopsies and 6.4% of the 234 pleural biopsies
  • The 15 patients were aged 29 to 65 years (mean 46.5 years), and all but three were male
  • No asbestos bodies or ferruginous bodies were seen in the tissue of any patient
  • Chest pain was the main presenting symptom in 14 of the 15 patients
  • All patients had massive pleural effusion, on the left side in ten and on the right in five
  • All patients had previously been treated elsewhere with tuberculosis drugs
  • On histology, 14 of the 15 tumours were epithelial type and 1 was sarcomatous type
  • Of the 12 patients whose tissue was tested, 9 showed CEA expression
  • Of the 3 patients with follow-up information, two had died within 6 months of the histologic diagnosis
• The authors' conclusion: The authors concluded that, contrary to the view that pleural mesothelioma is attributed to occupational asbestos exposure, this series of cases showed no association with asbestos
• Limitations the authors state:
  • Follow-up was obtained for only 3 of the 15 patients. The other 12 were lost to follow-up.
  • Tissue from 3 of the 15 patients was insufficient for immunohistochemistry

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, Sputum, Pleural Effusion, Pleural Thickening, Thoracotomy, Mesothelioma, Neoplasm.

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