Diffuse Mesothelioma

Our plain-English summary of Diffuse Mesothelioma, by W. Glyn Owen (1964).

The study

• Author: W. Glyn Owen
• Published: British Medical Journal, July 4, 1964.
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This study examined 17 cases of diffuse mesothelioma, 16 of the pleura and one of the peritoneum, from the Merseyside area. Most cases came from the files of the Liverpool Cancer Control Organization and the Liverpool Regional Thoracic Surgery Unit and covered 1955 to 1963. The author re-examined tissue samples, took occupational histories from patients or their next of kin, and looked for asbestos bodies in lung tissue. The patients were 12 men and five women. Strong evidence of asbestos exposure was found in 14 of the 17 (82%). Their jobs included laggers who insulated steam pipes, boiler-makers and sheet-metal workers in ship-repair yards, asbestos factory workers, and women who sorted used sacks. The shortest interval from first known exposure to the tumour was 13 years. Lung tissue was available in 10 cases, and asbestos bodies were seen in seven of them. In every case the diagnosis stayed uncertain until surgery or post-mortem examination. The author concluded that asbestos exposure is a major factor, and possibly an essential one, in causing diffuse mesothelioma. The author did not try to identify the type of 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: case series of patients with diffuse mesothelioma, with review of tissue samples, occupational histories and lung-tissue examination for asbestos bodies
• Who was studied: 17 patients with diffuse mesothelioma (16 pleural, 1 peritoneal) in the Merseyside area, drawn mainly from Liverpool cancer and thoracic surgery records, 1955 to 1963; 12 male and 5 female
• Exposure: Occupational asbestos dust exposure, assessed from work histories and from asbestos bodies in lung tissue. Jobs included lagging and heat insulation, ship-repair boiler-making and sheet-metal work, asbestos factory work, and sorting used sacks. The fiber type was not identified.
• Main results:
  • Asbestos exposure had occurred in 14 (82%) of the 17 cases
  • Of those with a clear exposure history, seven had worked in fire-proofing or heat insulation
  • Two female patients had spent many years sorting used sacking
  • The shortest interval from first known exposure to the tumour was 13 years
  • Lung tissue was available in 10 cases, and asbestos bodies were seen in seven of these
  • Lung fibrosis was minimal, which the author considered consistent with the absence of clinical features of pulmonary asbestosis
  • All patients with pleural growths complained of breathlessness
  • In every case the diagnosis remained in doubt until exploratory thoracotomy or post-mortem examination
  • Among the 12 post-mortem examinations, only one blood-borne metastasis was found
  • A mixed tissue pattern was present to some degree in all tumours studied
• The authors' conclusion: The author concluded that exposure to asbestos is a major factor, and possibly an essential one, in the causation of diffuse mesothelioma
• Limitations the authors state:
  • No information was sought from the factories or firms where the patients had worked
  • No attempt was made to identify the type of asbestos the patients were exposed to
  • Very little lung tissue had been preserved for examination

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Peritoneum, Thoracic Surgery, Asbestos Bodies, Asbestos Exposure, Insulator, Autopsy.

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