Document N258368zj2wwYmzgw6BOyjqER

08/06/2003 WED 09:41 FAX 312 996 1899 UIC LHS CHICAGO @003 560 MESOTHELIOMA--UEBEN & PISTAWKA Method Table 1.--Readings of Consultant Pathologist One hundred and sixty-two hospitals serving Case a population of 6% million people were re No. Mesothelioma Asbestos Bodies quested to report all mesotheliomas diagnosed between 1958 and 1963. Replies were received from 162 hospitals. Hospital records of 62 re ported cases were reviewed and only mesothe liomas confirmed by operation, biopsy, or au topsy were included in the study. Forty-two cases satisfied our enters. There were 34 meso 1-0 30 4-0 5-0 6-0 9-0 10-0 2-N Ves Not acceptable Probably not Yes Probably not Probably not Yes Yes No lung tissue Yes No lung tissue Yes Yes No lung tissue Yes No lung tissue theliomas of the pleura and eight of the perito neum. Among the pleural mesotheliomas there was a definite preponderance for occurrence on the right side of the chest. Of 34 pleural meso 3-N Probably not 4-N Not acceptable 6-N Yes 1-F Yes 2-F Yes No lung tissue No lung tissue No lung tissue No lung tissue No lung tissue theliomas only seven occurred on the left side, 26 on the right side, and two were not stated. Sections of as many of the tumors and lungs as possible were borrowed and reviewed by a 3-F Yes 1-Q Probably not 2-Q Yes 4-Q Yes S-Q Probably yes No lung tissue No lung tissue Yes No No single consultant pathologist familiar with mes otheliomas. In the 15 instances in which lung sections were available, they were examined for the presence of asbestos bodies. All slides were reviewed without the benefit of the complete history and autopsy protocol available to the pathologists who made the original diagnosis. Results of the 33 cases reviewed (Table) by our pathologist agreed with those of the outside pathologists in 17 cases; he rejected seven cases as unacceptable histologically, had serious doubts in nine cases (of these one slide was read as metastasis and one slide as anaplastic 6-Q 7-Q 8-Q 9-Q 10-Q 1-X 2-X 3-X 4-X 5-X 6-X 7-X 8-X 9-X 10-X Not acceptable Yes Yes Probably not May be Metast Yes. Yes Not acceptable Not acceptable Anaplastic malignancy Probably not No epithelial cells Mesothelioma must be proven Probably not Yes Yes' No No lung tissue No No No Yes No lung tissue No lungtlssue No lung tissue No No No lung tissue No lung tissue No lung tissue Yes malignancy). Of the 15 cases in which lung tissue was available, asbestos bodies were iden tified in seven. The discrepancies between the original pathological diagnosis and that of our patholo gist are reported to illustrate the difficulties and disagreements which are so frequent in the diagnosis of this tumor. For inclusion in this study the diagnoses of the originally reporting pathologists have been accepted and cases re ported by them were investigated. Efforts were made to obtain a complete em ployment and residence history for each pa tient Inquiry was also made into the employ ment history of family contacts. Data were obtained from the individual if alive, from fam ily members, or employers. Of the 42 patients, ten had definite occupa tional exposure to asbestos during lifetime, three were family contacts of asbestos workers, right either lived in the immediate neighbor hood of asbestos plants or had been employed Exposure of Ten Mesothelioma Patients Who Worked With Asbestos.--Patient 1-0 worked 35 years in the textile department of a large as bestos plant. Patients 2-0, 8-0, and 4-0 worked more than 20 years in asbestos insulation plants and pa tient 5-0 worked in an insulation plant for only one year. Patient'6-0 worked 15 years in a plant manu facturing acoustic tQe and linoleum. Patient 7-0 was a boiler maker in a railroad yard where, for 25 years, he worked on insula tion of steam engines. Patient 8-0 built bakery ovens in which large amounts of asbestos insulation were used. Patient 9-0 was a certified accountant who worked more than 30 years in the office of an asbestos textile plant Patient 10-0 was a plasterer who came in contact with a large amount of asbestos in his work. next to an asbestos plant Ten patients had a Of these ten men, patients 1-0, 8-0, and 10-0 questionable asbestos exposure and, in the oth had mesothriiomas of the peritoneum; the oth er 11 patients, either no asbestos exposure er seven men had pleural mesotheliomas. could be elicited on direct questioning or no Neighborhood Cases.--Patient 1-N was a 55- survivor could be located. year-old woman who never had any occupa- Arch Environ Health--Vol 14, April 1967