Malignant Mesothelioma of the Pleura

Mesothelioma Article

Malignant Mesothelioma of the pleura: current surgical pathology by © Robert C. Byrd Center For Rural Health

The usual gross and microscopic features of malignant mesolthelioma are well described in many standard texts, and require no reiteration in this volume. Instead, this account concentrates on the unusual or controversial, on the still-evolving role of immunohistochemistry for the discrimination between mesotheloma and its look-alikes, and on the differential diagnosis in pleural biopsies.

Malignant pleural mesothelioma

Malignant mesothelioma (MM) has recently attracted the attention of the media because of its relationship with professional and environmental exposure to asbestos. This tumour of the pleura is a disease which has emerged in significant numbers of patients during the last 30 years in the industrialized countries and its increasing incidence makes it of socio-economical interest.

The histological description of MM was first published by E. Wagner in 1870 and later by Klemperer and Rabin. A literature review of pathological cases of lung diseases befor 1940 identified 41 out of 46,000 autopsies as possible MM. In this review they mentioned a report from 1767 by Lieutaud who was the first to describe two possible cases of MM in an autopsy study. Since then, a number of case reports were published in which a relationship with asbestos exposure ws considered important but it was the report of J.C. Wagner in 1960 which identified a clear relationship between exposure to crocidolite mining and the development of MM. From that moment the association between asbestos exposure and MM ws accepted and a beginning was made to abandon the productionand processing of asbestos materials.

Asbestos: Mesothelioma

Mesothelioma is a rare cancer of the "mesothelial" cells that make up various membranes in a person's chest or abdominal cavity. This includes the pleura that encases the lungs. The pleura facilitates lung movement during breathing without motion sensation or nerve irritation inside the chest.

Mesothelioma is not lung cancer, although it frequently causes respiratory problems as the tumor grows and spreads along the surface of internal organs along serosal membranes. When it develops, mesothelioma is almost always caused by asbestos. There is some evidence that the virus SV40 may also be a factor in the disease in some people. It is not caused by smoking of any kind.

Mesothelioma most often occurs in two areas, forming extremely serious malignant tumors:

• Pleural Mesothelioma: cancer of the pleura, the membrane that lines the lungs and the chest cavity, and
• Peritoneal Mesothelioma: cancer of the peritoneum, which is the serosal membrane lining of the abdomen.
• Pericardial mesothelioma: pericardial mesothelioma cancer is a cancer of the pericardium, or heart sac.

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