Rarity of malignant mesothelioma prior to the widespread commercial introduction of asbestos: the Mount Sinai autopsy experience 1883-1910

Our plain-English summary of Rarity of malignant mesothelioma prior to the widespread commercial introduction of asbestos: the Mount Sinai autopsy experience 1883-1910, by J.A. Strauchen (American Journal of Industrial Medicine, 2011).

The study

• Author: J.A. Strauchen
• Journal: American Journal of Industrial Medicine
• Published: 2011;54(6):467-9
• Type of article: Historical article
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Most malignant mesotheliomas are related to asbestos exposure. Whether malignant mesothelioma occurs in the absence of asbestos exposure remains unsettled. To address this question we reviewed a series of 2,025 autopsies performed at the Mount Sinai Hospital between 1883 and 1910, prior to the widespread commercial introduction of asbestos.

Methods: Retrospective autopsy review.

Results: No cases of malignant mesothelioma were identified in 2,025 autopsies performed between 1883 and 1910.

Conclusions: Malignant mesothelioma was rare prior to the widespread commercial introduction of asbestos.

Copyright © 2011 Wiley-Liss, Inc.

In plain English

This brief report reviewed the records of 2,025 autopsies performed at the Mount Sinai Hospital in New York City between February 1883 and December 1910, a period the author placed before the widespread commercial introduction of asbestos. No individual asbestos exposure was assessed. A case counted as mesothelioma if tumor involved the pleura, spread on the serosa, and no other tumor was found. Malignant tumors were found in 281 of the 2,025 autopsies (13.9%), most often cancers of the stomach or esophagus (73 cases) and of the colon and rectum (43 cases). Lung cancer accounted for 6 cases. No definite cases of malignant mesothelioma were identified. One 1903 case, recorded as a possible pleural "endothelioma," was judged more likely to be metastatic carcinoma from an unknown site. The author concluded that the incidence of malignant mesothelioma before widespread commercial use of asbestos was very low. The author noted limitations. No slides survive, and many records lacked microscopic findings. Only patients who died in the hospital and were autopsied were studied, and they were mostly poor and immigrant.

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 of historical autopsy records (brief report)
• Who was studied: 2,025 autopsies performed at the Mount Sinai Hospital, New York City, between February 2, 1883 and December 31, 1910
• Exposure: No individual asbestos exposure was assessed. The study period was chosen as one before the widespread commercial introduction of asbestos and before enough latency for asbestos-related mesothelioma to develop.
• Main results:
  • Malignant tumors were identified in 281 of the 2,025 autopsies (13.9%)
  • Among the 281 malignant tumors, carcinoma of the stomach or esophagus was most common (73 cases, 26.0%), followed by carcinoma of the colon and rectum (43 cases, 15.3%)
  • Lung cancer was infrequent among the 281 malignant tumors (6 cases, 2.1%)
  • No definite cases of malignant mesothelioma were identified among the 2,025 autopsies
  • One 1903 autopsy in a 47-year-old woman, recorded as a possible primary pleural 'endothelioma' with metastases, was considered more likely to be metastatic carcinoma of unknown primary site
• The authors' conclusion: The author concluded that the incidence of malignant mesothelioma before the widespread commercial introduction of asbestos was very low.
• Limitations the authors state:
  • No slides survive. Early autopsy descriptions recorded only gross findings, and microscopic findings were not provided in all cases.
  • The lack of histology in the early autopsy records limits the review.
  • The term 'mesothelioma' was not well established until 1931, and such tumors had been recorded under other names.
  • Distinguishing mesothelioma from pleural metastases of adenocarcinoma remains problematic.
  • Selection bias: only patients who died in the hospital and were autopsied were studied, and hospitals then served a predominantly indigent and immigrant population.

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, Autopsy, Asbestos Exposure.

Related studies

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• Ferruginous bodies as markers of environmental exposure to inorganic particles: experience with 270 autopsy cases in Mexico — F.J. Arenas-Huertero, M. Salazar-Flores, et al. (1994)
• Role of CT in assessing pleural malignancy prior to thoracoscopy — R.J. Hallifax, M. Haris, et al. (2015)
• Asbestos fibers and pleural plaques in a general autopsy population — A. Churg (1982)
• Heterologous sarcomatoid pleural mesothelioma with osteosarcomatous differentiation: a report of autopsy case that accomplished trimodality therapy and review of the literature — H. Itano, T. Takeda, et al. (2020)
• Primary pleural angiosarcoma associated with pneumoconiosis: An autopsy case — K. Matsuda, T. Yamaryo, et al. (2015)

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