Mesotheliomas of the Pleura and Peritoneum

Our plain-English summary of Mesotheliomas of the Pleura and Peritoneum, by A.P. Stout (1951).

The study

• Author: A.P. Stout
• Published: Journal of the Tennessee State Medical Association, Volume 44. October 1951
• 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 article was the text of a talk by a Columbia University pathologist describing how the author's laboratory classified tumors arising from the lining of the chest (pleura) and abdomen (peritoneum). It was a descriptive account of the laboratory's collected cases and did not mention asbestos or any other exposure or cause. The author reported that the laboratory had gathered 72 cases of mesothelioma, 34 of the pleura and 38 of the peritoneum, grouped as fibrous or tubular, solitary or diffuse, and benign or malignant. Only four of the 34 pleural tumors were tubular, while 33 of the peritoneal tumors were tubular and five were fibrous. Malignant tubular mesotheliomas numbered 24 in the peritoneum (18 diffuse, 6 solitary) but only 3 in the pleura (2 diffuse, 1 solitary). The author could not explain these differences. The author reported that simple excision cured solitary benign fibrous mesotheliomas. In every solitary malignant fibrous case treated by less drastic measures, the tumor came back, spread, or both. The author concluded that recognizing these tumor types gave a firmer basis for treatment, and noted that some variants were known from only one or two cases.

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: Narrative presentation (a talk read to a medical association) describing a pathology laboratory's collected case series and classification of mesotheliomas
• Who was studied: 72 cases of mesothelioma (34 of the pleura, 38 of the peritoneum) collected in the Laboratory of Surgical Pathology, Columbia University, many sent from other parts of the continent; dates of the cases not stated
• Exposure: Not addressed: the article does not mention asbestos, any fiber type, or any other exposure or cause
• Main results:
  • Most pleural tumors were fibrous: only 4 of the 34 pleural mesotheliomas were tubular
  • Most peritoneal tumors were tubular: 33 of the 38 peritoneal mesotheliomas were tubular and 5 were fibrous
  • Malignant tubular mesotheliomas: 24 in the peritoneum (18 diffuse, 6 solitary) versus 3 in the pleura (2 diffuse, 1 solitary)
  • The laboratory's records held 36 primary tumors of the pleura, and all but two were considered mesotheliomas
  • Simple excision cured solitary benign fibrous mesotheliomas. In all solitary malignant fibrous cases treated by less drastic measures than radical removal, local recurrence, metastasis or both followed
  • 8 of the 9 solitary benign tubular mesotheliomas were tumors near the genital organs, which the author considered mesotheliomas, though there was no general agreement on this
• The authors' conclusion: The author concluded that, now that the tumor types derived from mesothelial cells could be recognized and labelled correctly, there was a more secure foundation for treating these tumors
• Limitations the authors state:
  • Some tumor variants were known from only one or two cases, so much remained to be learned about them
  • There was no general agreement that the small genital-area tumors counted here were truly mesotheliomas
  • The author could not explain the differences in tumor types between the pleura and the peritoneum

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Peritoneum.

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