Diffuse Malignant Mesothelioma of the Pleura: A Review of 37 Cases

¹ Mayo Clinic and Mayo Foundation: Department of Surgical Pathology
² Mayo Clinic and Mayo Foundation: Department of Internal Medicine
³ Mayo Clinic and Mayo Foundation: Department of Surgery

In a period of 22 years, 37 patients with diffuse, malignant mesothelioma of the pleura were seen in a large patient population. These patients lived mostly in relatively small midwestern communities in the United States. Three patients had histories of definite occupational or environmental exposure to asbestos, seven had histories of probable exposure, and 27 had histories of no known exposure. "Asbestos bodies" were found in the lung tissues of all three of the patients with definite asbestos-exposure histories, three of the seven patients with probable exposure, and only five of the 27 patients with no exposure. Slight pulmonary interstitial fibrosis was noted in 17 of the 37 patients. Histopathologically, 25 of the diffuse malignant growths were classified as tubulopapillary, seven as fibrous, and five as bimorphic. The survival rate of patients with these malignant growths was low, and 28 of the 37 patients had died, with an average survival of 18 months from the onset of symptoms for those with the tubulopapillary type, eight months for those with the fibrous type, and seven months for those with the bimorphic malignancies.