The Clinical And Radiological Aspects Of 185 Cases Of Malignant Pleural Mesothelioma

Our plain-English summary of The Clinical And Radiological Aspects Of 185 Cases Of Malignant Pleural Mesothelioma, by Y.I. Baris (1980).

The study

• Author: Y.I. Baris
• Published: Biological Effects Of Mineral Fibres (J.C. Wagner, Editor), Lyon: Iarc Scientific Publications, Volume 30, Pp. 937-947 (1980)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 002170. The article is still under copyright, so we describe it here rather than post it.

In plain English

This case series from Hacettepe University in Ankara, Turkey, reviewed 185 cases of malignant pleural mesothelioma collected between 1975 and 1979, which the author described as environmentally caused. Group 1 was 122 people from villages near asbestos deposits, where mineral studies found mostly tremolite and chrysotile asbestos. Only five of them had possible occupational exposure. Group 2 was 63 patients from the Cappadocia region, 51 of them from the village of Karain, where there are no asbestos deposits but zeolite occurs. The illness began with insidious chest pain. Patients took a mean of six months to reach hospital, and the average time from first symptoms to death was nearly 18 months. Pleural effusion was the most common chest X-ray finding: 64 of 92 Group 1 patients (69.5%) and 32 of 63 Group 2 patients (50.7%). Tumour grew at biopsy or surgery sites in 11 Group 1 cases and six Karain cases. The author concluded that the high occurrence of mesothelioma in Karain and Tuzköy was probably due to zeolite. The author also found that patients were younger at death than people with occupational mesothelioma, and explained this by exposure beginning soon after birth.

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: review of clinical, laboratory and radiological records of mesothelioma patients
• Who was studied: 185 cases of malignant pleural mesothelioma collected in Turkey between 1975 and 1979. Group 1 was 122 subjects from villages near asbestos deposits in rural central Anatolia; for 30 of these referred cases only age, sex and birthplace were recorded. Group 2 was 63 cases from the Cappadocia region, including 51 from Karain and two from Urgup.
• Exposure: Environmental exposure to fibrous minerals. Group 1 villages had mostly tremolite and chrysotile asbestos in the environment, and only five Group 1 patients had possible occupational exposure. Group 2 villages had no asbestos deposits but had zeolite (erionite-type) fibres.
• Main results:
  • Onset in all cases was insidious chest pain. The mean interval before reaching hospital was six months.
  • The average duration of illness from onset of symptoms to death was nearly 18 months.
  • Pleural effusion on chest X-ray: 64 of 92 Group 1 patients (69.5%), 32 of 63 Group 2 patients (50.7%), and 96 of 155 overall (61.9%).
  • Tumour implantation at needle biopsy, thoracoscopy or thoracotomy sites was found in 11 cases of Group 1 and six cases from Karain.
  • Sympathetic nerve involvement was found in seven patients, and hypoglycaemic features in two.
  • Tremolite- and chrysotile-type asbestos fibres were found in the lung tissue of some Group 1 cases. Zeolite fibres were found in soil and rock samples of Tuzköy and in the lung tissue of one patient.
  • Three patients with mesothelioma had been followed up after a diagnosis of asbestos-caused pleurisy.
• The authors' conclusion: The author concluded that the high occurrence of mesothelioma in Karain and Tuzköy is probably due to a fibrous silicate (zeolite). The patients' lower age at death compared with occupational mesothelioma was attributed to exposure beginning immediately after birth. Calcified pleural plaques and chronic fibrosing pleuritis were described as possible precursors of mesothelioma.
• Limitations the authors state:
  • For 30 referred Group 1 patients, only age, sex and birthplace were recorded.
  • Asbestos fibres reported in the pleural tissue of one Karain patient were thought possibly to be a technical error, because asbestos fibres were found in the formalin used to fix tissue.
  • The author believed the true frequency of Horner's syndrome would be higher with closer follow-up.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Tremolite, Chrysotile, Occupational Exposure, Cappadocia, Karain, Zeolite, Pleural Effusion.

Browse return to medical research.