Document n9JRm9g0208OKvmJXy8pw3ez6

Hrpniueij (roui THE H'N'C* !j;ti*r:ia;i<.-n:vi Armientv i\isiii.-*y M'w:joh Xu- A bjl;nnof. T)i WilbiUlJ* 4 "'ilUiuj CvRI{-:inv '"..;\vr:Ui I lOnT. Th* luicreauoual AraHriav ui Pathology fnnttti in' th Siaitt of .l*rmn Symposium on Geographic Pathology of Pulmonary Di-ease Chapter 19 ` Geographic Patliologv of Pleural Mesothelioma* JACOB CEtTRG AND IRVING J. 5ELIK0FV PLAINTIFF'S' EXHIBIT Geographic pathology of mesothelioma would have been a difficult subject to discuss in a meaningful maimer even 10 years ago, dealing, as it did. with a rare nmor o: a poorly denned distribution, unknown etiology and questionable im portance. Today mesothelioma is reported with increasing frequency. New con cepts have arisen concerning its etiology, which, although still tentative, are of great- potential importance in understanding the development of mesothelioma in parti:ular and of cancer in general in a modem industrial society. By definition, mesothelioma is a tumor arising from the mesothelial surface lining cr from subsurface tissue of serosal cavities--pleura, peritoneum and pericardium. In the past, some pathologists20-44 have questioned the existence of such tumors and considered a great majority, if not all, oi the reported instances as examples of metastases from other sites. However, most investigators, begin ning with Wagner in 1S70,37 have accepted the existence of primary' pleural, peritoneal and pericardial tumors. The name mesothelioma was first proposed by Miller and Wynne in 190817 and popularised by Klemperer and Rabin in 2931.14 The incidence of mesothelioma has been calculated by various authors at 1:1000 to 1:10,000 autopsies. This 10-fold variation is caused, in part, by the small number of cases on which the calculations were based and in part by differences in diagnostic criteria, as discussed later. By 1950, Hochberg found 223 cases of pleural mesothelioma in the litera ture.10 Most of the reports consisted of single or, at most, a few cases, borne figures on the behavior of the tumor could be gleaned from these reports. Male patients predominated over iemale in a ratio of nearly 2:1. Although mesothe liomas were observed at any age from childhood on, at least 50 per cent oc curred between 40 and 60 years. The tumor was found a little more often on the right than on the left side, but this is not surprising because the right pleura has a slightly larger surface than the left. No specific pathologic features were asso ciated with any one geographic area and no pattern of occurrence was apparent. This work was supported by tbs Health Research Council oi the City of New York. Groat U-1272. 2S4 2% The Lung . REFERENCES 1. Anderson, W. A. D. Contributions of pathology o problem* of human and s\r r:mental luaz raucer. Ward Burdick Award Address. Amer. J. Clin. Path. J,ti: 1--26.1966. 2. Cartier, P. Discussion of "Survey of some current British and European studies of oc cupational tumor problems- by W.-E. Smith. Area. Indnolr^H'/g. Occnp. Med. : Chicago) 5: 242-263. 1952. ' 3. Cauoa, D., Totten, R. S., aad Grose, P. Asbestos bodies in human lungs ut autopsy. J. A. M. A. JH3: 371-373, 1965. , 4. Clutnc, J., Ro.ea, S. H., aad Moolten. Histological charar.eristies of mesothelioma associated wiih asbestos. A/m. X. Y.Acnd. Sci. 132: 614--*22, 1965. 5. Doll. R. Mortality from lung cancer in asbestos '.corkers. 3At. J. Indnslr. Med. 12: S1-S6. 1955. 6. Ehnes. P. C.. MrCaughey. W. T. E.. and Wade. 0. L. D.rf'.Jse mesothelioma of the pleura and asbestos. Bril. Mtd. J. 1: 2o*>-->5:3. 1965. 7. Emicknap. J. B., and Smither. W. J. Peritoneal tumours in asbrstoiis. Bnt. J. Induotr. Med. 11: 20-31. 1064. S. Geoeruphical Pathology Section. International Union Against Cmcer. Report and recom mendations of the workin* group ca asbestos and canter. A m. .V. Ac*'l. Sci. 132; 706-721. 1965. . '' 9. Harinzton. J. S. Occurrence of oils containing 3:4 benzpyrene and related substances in Acb-s*0$. Xainre (.London) 102: 43-45, 1962. 10. Hot-biers. L. Endoth-Uoma (mesothelioma) of the pleura. Amev. Rev. Tuberc. 33: IK-173.1*51. 11. Hourihane. D. O'B. The pathology of mesotheliomata and an analyst* of the associa tion "'.h asbestos exposure. Thorax 10: 26S-27S, 1964. 12. Houriranj. D. O'B. Discussion. Ann. X. Y. Acad. Sci. 132: 251,1965. 13. Jacob. G.. lz i Anspaeh, M. Pulmonary meoplasia among Dresden asbestos workers. A/*/.-. Acad. Sci. 132 : 536-659,1965. 24. Klemperer. and Rabin. C. B. Primary* neoplasms of the pleura. A report of five cases. Arch. P.-r':. (Chicago) 11: 3S5-412, 1931. ' 15. Maximow. A. 1`cber das MesotheJ. (Drrkzellen der seriisen Haute) und die Zellen der sere-sen Exsudate. Arch. Exp. Ze!lfor*ch. 1-42, 1927. 16. Meurman. L. Asbestos bodi.es and pleural plaques in a Finnish series of autopv cases. Act". P.r.h. Microbial. Scnnd., suppl. 1S1. 1-107. 1966. 17. Miller. J.. and Wynn, W. H. A malignant tumor arising from rhe endothelium of the peri'eneum and producing a mucoid ascitic fluid. J. Path. Pact. 12: 267-27S. 19QS. IS. Xageis*-C2v.dr. G. Discussion. A/m. X. 1`. Acad. Sri. 132: 6S4. 1965. 19. Newr.ottse. M. L.. and Thompson. H. Mesothelioma of the pleura and peritoneum fol low-in? exposure to asbestos in rhe London area. Brit. J. !nd>i*tr. Med. 22: 261-259, lf-55. 20. Rob-rvjs. 3. E. "Endothelioma" of the pleura. J. Canccr Iia. S: 317-375,1924. 21. Ro*en. 5 H. Personal communication. 22. San--. M. E., Weiss. E.. and Gault. E. >. Pleural ats-fOtheliuma. further cud-nee of its histtzen-sis. J. Thome. Camuir. S'.rg. 20: 753-755. 20-50. 23. Schspers. G. W. H. Discussion. Ann. X. 1*. Acad. $ci. 122: 2-A 1965. 24. Se-ikox. I. J., Chur?. J.. and Hammond. E. C. Asbestos exposure and neoplasia. J. A. M. A. US: 22-25."2964. 25. 5-iik-_5. I. J.. Chui-g. J.. and Hammond. E. C. Relation be-meea asbestos exposure aad neoplasia. Xe>c Eng. J. Me-i. 212: 560-565. 1965. 26. Semb. G. Dititwe mallgnaac pleural mesothelioma. A ^iinicoyathological study of 10 :a*ai cases. Acftt. Chic. S*'and. 123: 7$--M. 1763. 27. 51u:-Crnmer. G. K. Asbestosis in South Africa--Crrr.sin seographieai .and environmen tal considerations. A/:.:. .V. Y. Acad. Sci. 232: 215-234. 1965. Smith. W. E,, Miller, J,, Chur?, J.. and Seiikott, I. J. Mesotheliomas in hamsters follotvin? intrapleural injection of asbestos. J. Mount Sinai Hocp. X. Y. 22: 1-6. 1965. Pleural Mesothelioma y.t: 20. Smith, W. E., Miller, L., El.'.u*er, R. .. uud Hubert. D. P T-.h* ;jr mve-unuiy vi asbestos, .-inn. A*, }\ Acad. Set. iJ2; 43t>-4co, 1065. ' 30. Smither, "W. J. Secular ehaages in asbestosis in on asbestos factory. Ann. .V. V. Acad Set. 232: 166-1S1, 1965. ' 32. Stout, A. P. Mesotheliomas of the pleura anti peritoneum. J. Tennessee Mid. Ass. 44: 409-411, 1951. 33. Stout, A. P. Discussion: Asbestos and neoplasia: Diffuse mesothelial tumors. Ann. .V. Y. Acad. Set. 232: 680-852, 1965. - ..... ___ - 33. Stout, A. P., and Murray, M. Pw localized pleural mesothelioma, investigations oi its characteristics and histogenesis. A~;h. Path. (Chicago) S4: 531-964, 1942. 34. Thomson, J, G., ICaschula. R. 0. C., and MacDonald, R. Asbestos as a modem urban hazard. 5. AJr. Med. J. 27: 77-51.15*63. 35. Urschel, H. C., and Paulson, D. L. Mesotheliomas oi tns pleura. Ann. Thorne. Sxrg. l: 559-0574, 1985. ' 36. Tan tier Srhooi, H. C. M. Asbestos* and tumors or the pleura. Xederi. T. Geneesk. 202: 1135-1125,1958. 37. Vagner. E. Dns tuberkeiahnlicae Lymphaaecom. Arch. Keiik. 21: 497-523,1$70. 3S. Wagner, J. C. Experimental production of nesotheiiai rumours oi the pleura by im plantation oi dusts in laboratory animals. Xature (London) 106: 1S0-1S1,1962. 39. Vagner, J. C., Munday, D. En and Harington, J. S. HUtochemical demonstration, oi hyaluronic acid in phrcrai mesotheliomas. J. Path. Bad, 34: 73-7S, 1962. 49. `TTaener, J. Cn Sieges, C. A., and Marchaad, P. Diffuse pleural mesothelioma and as bestos expostire in the North Western Cap Province. Brit. J. Jndustr. Mad. 17: 2S0-2T1. 1960. 4L "e:5ter, I. Mesotheliomatous tumors in South Africa: pathology and experimental i'.noioey. Ann. A*. T. Accd. Set. 132: 623-646, 1965. - 42. W--fj*- H. W. Cher den Limgenkrcbs bei Asoestose. Deutsch. Arch. Klin. Med. 251: IS4-2W, 1043. 43. A. Plsurakrebs bei Limgenasbestose, in Vivo morphologisch gesichert. Medisinische 4i -r. iJ. 44. Wilks. H. A. Pathology of tumours, 3rd ed. London, Buttenvorth, 1960. 45. Winslow. D. J., and Taylor, H. B. Malignant peritoneal mesotheliomas: A clinicopathological analysis of 12 coses. Cancer 23: 127-136, 1960. 46. TTyj3. H. Asbestosis. Postgrad. Med. J. 23: 631-638,1949.