Document MM1vBkYYnKQge172Qv1GZzJkk

6 In the final stages, the tumor spreads also into the pleura of the lower and upper mediastinum, and it shows at this location the same changes of the pleura that are close to the heart, it quickly spreads to the pericardium. Due to the unfortunate localization these patients arrive a'd exitum before the tumor can spread to the are of thoracal pleura. These cases, which occur rarely, then create the impression of an isolated mesothelioma of the pericardium, as it was seen in a similar way in the two cases that were mentioned above. Discussion Today, there are no doubts anymore about the link of an asbestosis of the lungs and a carcinoma of the bronchi, which was also reflected in the insurance law. Thus, an asbestosis linked with a carcinoma of the bronchi is recognized as a job-related disease which entitles the worker to workman's compensation. In recent months, the reports about a linkage of diffuse malignant pleural mesotheliomas with lung asbestosis have beocome more frequent. Such tumors, which are otherwise very rare, were observed, most of all, after job-related exposure*. In recent times, Wagner and associates reported, as mentioned above, about 84 such tumors, for which also a non-job related risk has to be takeniinto consideration,. Jacob and Bohlig already pointed out that an increased number of serosa tumors could be observed not in frequency in connection with an asbestosis. First reports of a pleural mesothelioma in connection with an asbestosis in Germany date back to Wedler. Unfortunately, this report did not study the cases - which are given in the chart as number 1-6. Possibly, the connection between the asbestos dust exposure could have been established even then, especially even in our cases this connection was only established in retrospect. Mesotheliomas after an exposure to asbestos are, in the overwhelming number of cases, located in the pleura, rarely in the peritoneum. In the area of the silicosis information center Dresden, several cases of peritoneal tumors were registered after an exposure to asbestos in a job-related context. There can be no precise information about the frequency of the meso thelioma in the pleura. It should be mentioned, though, that out of 21,541 sections within the period from 1950 to the first quarter of 1964, 27 cases were observed. Just as the pleural calcifications usually did not show a dimultaneous j . lung fibrosis, our studies show also that there is no connection between the degree of the changes in the lungs due to asbestosis and the occurrence of mesothelioma of the pleura. Only in two cases was there 1 a clear asbestosis. Through anamnesis a connection with exposure to asbestos dust could be established in 18 cases. Beside the nine zthat were exposed to the asbestos dust on .the job, the nine cases from : the neighborhood of asbestos factories can be, with great probability, I traced back to an exposure of asbestos dust. The finding of asbestos * particles in four cases can be taken as a sure proof such a non-job j related asbestos risk. HFM - 005091 8003 1176