Mesothelioma in an agricultural community of India: a clinicopathological study

Our plain-English summary of Mesothelioma in an agricultural community of India: a clinicopathological study, by P. B. Das (1976).

The study

• Author: P. B. Das
• Published: Aust. N.Z. J. Surg., Vol. 66, No. 3, August 1976
• 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 case series described five primary mesothelioma patients treated at Wanless Hospital, Miraj, Maharashtra, India. The authors reported all five came from a rural agricultural community with no chance of asbestos exposure. Four belonged to the farming community engaged in sugar-cane farming and jaggery and molasses making, one of them a housewife in a sugar-cane farming family; the fifth was a sugar-factory chemist. Four tumours arose from the pleura and one from the pericardium. Four were diffuse malignant mesotheliomas and one was benign, though the authors noted it was not localized. Tumour types were tubulopapillary (two), fibrous (two) and bimorphic, or mixed (one). Among three patients who had lung tissue removed, apparently no asbestos or asbestos-like bodies were found. Two patients whose tumours were removed were symptom-free 26 and 24 months after surgery. Two given radiotherapy and cyclophosphamide were doing well at ten and eight months. One did not respond and developed scalp metastases. The authors wrote that there must be a farming-related rural factor inducing mesothelioma as asbestos does. They called the sugar-cane link open to speculation and needing further investigation.

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 (clinicopathological report of five patients)
• Who was studied: Five patients with primary mesothelioma from a rural agricultural community, treated at Wanless Hospital, Miraj Medical College, Maharashtra, India
• Exposure: The authors reported no chance of asbestos exposure. They described four patients as belonging to the non-industrial farming community engaged in sugar-cane farming and jaggery and molasses making. One of these (Case 2) was a housewife in a rural family engaged in sugar-cane farming. The fifth was a chemist in a local sugar factory.
• Main results:
  • Four tumours were of pleural origin and one (Case 1) was of pericardial origin
  • Four were diffuse malignant mesotheliomas and one (Case 2) was a benign mesothelioma, which the authors noted was not localized
  • Histological types: tubulopapillary (Cases 1 and 3), fibrous (Cases 2 and 4), bimorphic or mixed (Case 5)
  • In the three cases with pulmonary resection, lung tissue was examined for asbestos or asbestos-like bodies, and apparently none was found
  • Case 2 was a housewife in a rural family engaged in sugar-cane farming
  • The fifth patient was a chemist in a local sugar factory
  • Cases 1 and 2, whose tumours were satisfactorily removed, remained asymptomatic 26 and 24 months respectively after surgery, with no evidence of recurrence
  • Cases 3 and 4, given radiotherapy with cyclophosphamide, were still doing well ten and eight months respectively after diagnosis
  • Case 5 did not respond to radiotherapy and chemotherapy
  • The only distant metastasis (scalp nodules) occurred in Case 5. In Case 4 a deposit grew on the chest wall along a thoracocentesis needle track.
• The authors' conclusion: The authors concluded that their findings indicated there must be a factor in non-industrial rural areas connected with farming that is responsible for inducing mesothelioma in the same way as asbestos, and that further investigations are required to prove this.
• Limitations the authors state:
  • The authors stated that whether the association with sugar-cane farming and allied trades has any bearing on the cause remains open to speculation
  • The authors stated that experimental work in laboratory animals may be essential to prove the point

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Pleura, Pericardium, Tubulopapillary.

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