Hasan F M, Nash G, Kazemi H
Am Rev Respir Dis. 1977 May;115(5):761-8. doi: 10.1164/arrd.1977.115.5.761.
A continued increase in the incidence of diffuse mesothelioma has been attributed to greater industrial use of asbestos but is also due in part to wider acceptance of this tumor by pathologists. In this retrospective study, the epidemiology, clinical presentation, and pathology of asbestos and non-asbestos-related mesothelioma from a major urban hospital were reviewed. Of the 36 cases of mesothelioma on file, 19 were not associated with exposure to asbestos. Although a retrospective study raises the possibility of inadequate occupational histories, the lack of history of asbestos exposure correlated with postmortem histology by light microscopy. When postmortem material was reviewed, evidence of asbestos exposure was present in all cases of mesothelioma with history of exposure to asbestos, and in no cases in which the patient denied history of asbestos exposure. Using strict histologic and histochemical criteria, the diagnosis of mesothelioma was confirmed in 8 of 9 patients with asbestos-related mesothelioma but in only 4 of 13 cases of non-asbestos-related mesothelioma. The diagnosis of diffuse methelioma is often difficult to make even wtih complete autopsy examinations. It should be entertained only with adherence to strict clinical and pathologic criteria, especially in women with no history to exposure to asbestos dust.
弥漫性间皮瘤发病率的持续上升被归因于石棉在工业上的更多使用，但部分原因也是病理学家对这种肿瘤的认可度提高。在这项回顾性研究中，对一家大型城市医院中石棉相关和非石棉相关间皮瘤的流行病学、临床表现及病理情况进行了回顾。在存档的36例间皮瘤病例中，19例与石棉暴露无关。尽管回顾性研究增加了职业史记录不完整的可能性，但缺乏石棉暴露史与光镜下尸检组织学结果相关。当对尸检材料进行复查时，有石棉暴露史的所有间皮瘤病例中均有石棉暴露证据，而在患者否认石棉暴露史的病例中则未发现。采用严格的组织学和组织化学标准，9例石棉相关间皮瘤患者中有8例确诊为间皮瘤，而13例非石棉相关间皮瘤病例中仅有4例确诊。即使进行完整的尸检，弥漫性间皮瘤的诊断往往也很困难。只有严格遵循临床和病理标准才能做出诊断，尤其是对于无石棉粉尘暴露史的女性患者。
