The pathology of mesotheliomata and an analysis of their association with asbestos exposure

Our plain-English summary of The pathology of mesotheliomata and an analysis of their association with asbestos exposure, by D.O. Hourihane (Thorax, 1964).

The study

• Author: D.O. Hourihane
• Journal: Thorax
• Published: 1964;19(3):268-78
• Cited by: 93 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. 001561).

Abstract

A study of the pathology of 34 cases of primary tumours (mesotheliomata) of the pleura and peritoneum shows these to be distinct and recognizable neoplasms which can be distinguished from primary carcinomata of the lung or other viscera. The association of these tumours with asbestos bodies in lung tissue is confirmed. Many of the cases gave no history of industrial exposure, and it is possible that temporary or relatively trivial exposure may have occurred. Once symptoms from the tumours have arisen, the prognosis appears to be measured in months rather than years.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This was a review of necropsy (autopsy) files at The London Hospital, from 1917 to 1962, for cases recorded as primary diffuse tumours of the pleura or peritoneum (mesotheliomata). Using strict pathological criteria, the author accepted 17 of 38 pleural cases and 17 of 55 peritoneal cases, a total of 34, and graded each as certain or probable. Asbestos bodies were found in the lungs of 6 of 7 certain pleural cases, 1 of 10 probable pleural cases, 7 of 11 certain peritoneal cases and 1 of 2 probable peritoneal cases. Among rejected cases with lung tissue, 1 of 16 pleural and none of 11 peritoneal cases had asbestos bodies. None were found in 50 consecutive necropsies that excluded chest tumours, and 3 of 50 lung cancer necropsies had them. The author concluded that the association of these tumours with asbestos bodies in lung tissue was confirmed. The author noted that many cases gave no history of industrial exposure, and that temporary or relatively trivial exposure may have occurred. Because usually only one lung block was available, the author regarded the asbestos body findings as the lowest possible.

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 pathology review (case series) of necropsy records and slides. Rejected cases and two series of consecutive necropsies were used for comparison.
• Who was studied: Necropsy cases at the Bernhard Baron Institute of Pathology, The London Hospital, London, 1917 to 1962. There were 38 recorded pleural cases (17 accepted: 7 certain, group A; 10 probable, group B) and 55 peritoneal cases (17 accepted: 13 certain, group C; 4 probable, group D), giving 34 accepted mesotheliomata in total. Comparison groups were 50 consecutive necropsies of lung carcinoma and 50 consecutive necropsies excluding tumours in the chest.
• Exposure: Asbestos exposure was judged mainly by asbestos bodies seen in lung tissue on routine stains. A case was recorded as asbestosis if lung fibrosis was also present. Some histories of industrial exposure were noted. No fiber type is named.
• Main results:
  • Group A (certain pleural mesotheliomata, 7 cases, ages 37 to 77): asbestos bodies were found in the lung in 6. Only case 2 was known to have had asbestosis during life, with a long history of industrial exposure.
  • Group B (probable pleural mesotheliomata): 10 had lungs available, and 1 had asbestos bodies or fibres (Table III, 10%).
  • Group C (certain peritoneal mesotheliomata): 11 cases had lung blocks available, and asbestos bodies were found in 7 (63%).
  • Group D (probable peritoneal mesotheliomata): of 2 cases with lung available, asbestos bodies were seen in 1 (50%).
  • Rejected pleural cases: of 21, 16 had lung tissue, and 1 showed an asbestos body. That case was thought to be a neurofibrosarcoma.
  • Rejected peritoneal cases: 11 had lung tissue available, and none showed asbestos bodies.
  • In 50 consecutive necropsies (tumours in the chest excluded), no asbestos bodies were found.
  • In 50 consecutive necropsies of carcinoma of the lung, 3 had asbestos bodies or fibres (6%) (Table III, group G).
  • The association with asbestos bodies was not restricted to any histological type of tumour. Both epithelial and fibromatous elements were found in 41% (14 cases).
  • Asbestos bodies were never found in the pleura, within the tumour, or in any other organ.
  • In case 7, asbestos bodies were found at necropsy, but close questioning of relatives obtained no history of industrial exposure.
• The authors' conclusion: The author concluded that these tumours are distinct, recognizable neoplasms and that their association with asbestos bodies in lung tissue was confirmed. The author described the difference from the rejected cases as a clear significant difference. Many cases gave no history of industrial exposure, and the author suggested temporary or relatively trivial exposure may have occurred. Once symptoms arose, prognosis appeared to be measured in months rather than years.
• Limitations the authors state:
  • In most cases only one lung block was available, so the author regarded the asbestos body incidence as the lowest possible.
  • Unidentified brown round bodies were counted as negative findings.
  • Some cases had very few bodies, so a random lung sample might have shown none.
  • For some probable pleural cases, primary lung carcinoma could not be firmly excluded.
  • The study was not a clinical study.
  • Most tissues were formol fixed, so the hyaluronic acid staining reaction could not be shown.

Topics

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

Medical terms in this study, explained in our Lexicon: Pathology, Asbestos Exposure, Pleura, Peritoneum, Neoplasm, Asbestos Bodies, Prognosis.

Related studies

• Diffuse mesothelioma and exposure to asbestos dust in the Merseyside area — W.G. Owen (1964)
• Exposure to asbestos and mesothelioma of the pleura — P.B. Fowler, J.C. Sloper, et al. (1964)
• Peritoneal tumours in asbestosis — J.B. Enticknap, W.J. Smither (1964)
• Diffuse mesothelioma of the pleura and asbestos — P.C. Elmes, W.T. McCaughey, et al. (1965)
• Asbestos bodies in human lungs at autopsy — D. Cauna, R.S. Totten, et al. (1965)
• Pathology analysis for mesothelioma study in the United Kingdom: Current practice and historical development — B.W. Case (2016)

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