Two malignant pleural mesotheliomas with unusual histological features

Our plain-English summary of Two malignant pleural mesotheliomas with unusual histological features, by B Goldstein (1979).

The study

• Author: B Goldstein
• Published: Thorax, 1979, 34, 375-379
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 004248. The article is still under copyright, so we describe it here rather than post it.

In plain English

This was a report of two cases of malignant pleural mesothelioma examined after death in South Africa. Besides typical mesothelioma, both tumours contained cartilage, bone formation and fibrochondrosarcomatous tissue. The first patient, a 35-year-old black woman from the Kuruman area of the north-west Cape Province, had no known history of asbestos exposure. Electron microscope analysis of her lung tissue found several crocidolite asbestos fibres. Tumour up to about 2 cm thick encased her left lung, and cuffs of cartilage and bone surrounded blood vessels and bronchioles in the lung. The second patient, a 38-year-old black man, had worked at an amosite mine for 1140 underground and 540 surface shifts. Tumour about 5 cm thick filled his right pleural space, and his lungs held numerous asbestos bodies and fibres. The author weighed several explanations. In the author's view, several features favoured the cartilage and bone being part of the tumour, although two separate tumours could not be excluded entirely. No biochemical studies were done.

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 report (two cases), pathology description with discussion
• Who was studied: Two patients in South Africa examined at necropsy. Case 1 was a 35-year-old black woman who had lived in the Kuruman area of the NW Cape Province. Case 2 was a 38-year-old black man whose cardiorespiratory organs were sent to the National Research Institute for Occupational Diseases, Johannesburg.
• Exposure: Case 1: no history of asbestos exposure could be elicited, but electron microscope microprobe analysis of digested lung tissue showed several crocidolite asbestos fibres. Case 2: worked on an amosite mine as an underground lasher for 1140 shifts and as a surface lorry loader for 540 shifts, plus one year each in gold and coal mines.
• Main results:
  • Case 1: the left lung was encased in tumour up to about 2 cm thick, with calcification.
  • Case 1: the lung showed no evidence of asbestosis, and ferruginous bodies were not seen on ordinary examination.
  • Case 1: electron microscope analysis after digestion of lung tissue showed several crocidolite asbestos fibres.
  • Both cases: besides typical mesothelioma, the tumours contained cartilage with foci of calcification and ossification, and fibrochondrosarcomatous tissue.
  • Case 1: cuffs of cartilage and bone were found around blood vessels and bronchioles in the lung parenchyma.
  • Case 2: the right pleural space was filled with tumour about 5 cm thick that invaded the superior vena cava and extended into the right atrium.
  • Case 2: sections of both lungs showed numerous asbestos bodies and asbestos fibres, with moderate interstitial fibrosis.
  • Case 2: a tumour nodule in the right lower lobe showed chondrosarcoma in the lung tissue.
  • The author considered several explanations (tuberculosis, a substance secreted by the tumour, two separate tumours, calcified pleural plaques) and stated that several features favoured the view that the cartilage and bone were part of the tumour itself.
• The authors' conclusion: The author concluded that the two cases illustrate mesothelioma with typical features together with areas of fibrochondrosarcoma and the formation of bone and cartilage.
• Limitations the authors state:
  • Biochemical studies to test whether the tumour produced a substance promoting cartilage and bone formation had not been carried out.
  • The possibility that two separate tumours were present could not be excluded entirely.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma, Cape Province, Asbestos Exposure, Crocidolite, Amosite, Asbestos Bodies.

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