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Published on: December 21, 2019
Environmental malignant mesothelioma in southern Anatolia: a study of fifty cases
E H Zeren1, D Gümürdülü, V L Roggli
1Department of Pathology, Cukurova University, Adana, Turkey. hzeren@superonline.com
Abstract:
Malignant mesothelioma is a highly aggressive tumor of the serous membranes, which in humans results from exposure to asbestos and asbestiform fibers. Although occupational malignant mesothelioma is still the most common form of this lesion, naturally contaminated soil can play an important role in the development of environmental malignant mesothelioma in some parts of the world. Fifty cases of malignant mesothelioma (MM) from southern Turkey with no occupational history of asbestos exposure were reviewed regarding pathologic and clinical features. A case of hyaline fibrous plaque of the pleura was also included in this series. Histologically the cases were classified as epithelial (36 cases); sarcomatous (7 cases); and biphasic (7 cases). One of the sarcomatous cases was desmoplastic. Ultrastructural examination of the tumor tissue in three cases revealed long-surface microvilli in epithelial cells. Interstitial cells of the lung in one case showed electron-dense asbestos fibers in the cytoplasm. Mineralogical analyses of the lung tissue in three cases of MM and the case of pleural plaque showed high amounts of asbestos fibers most consistent with tremolite and actinolite. The clinical and pathologic features of our cases support that the environmental inhalation of asbestos is still a major health problem in some parts of Turkey.
Insights
Environmental asbestos exposure, particularly from contaminated soil, is a significant cause of malignant mesothelioma (MM) in Turkey. This study found high asbestos levels in patients with MM, confirming environmental inhalation as a major health concern.
Area of Science:
- Environmental pathology
- Oncology
- Mineralogy
Background:
- Malignant mesothelioma (MM) is an aggressive tumor linked to asbestos exposure.
- While occupational exposure is common, environmental sources like contaminated soil are implicated in some regions.
- Southern Turkey presents a unique setting for studying environmental MM due to potential soil contamination.
Purpose of the Study:
- To investigate the clinicopathologic features of malignant mesothelioma in southern Turkey.
- To determine the role of environmental asbestos exposure in non-occupational MM cases.
- To identify asbestos fiber types in affected lung tissues.
Main Methods:
- Retrospective review of 50 malignant mesothelioma cases and 1 pleural plaque case from southern Turkey.
- Histopathological classification of mesothelioma subtypes (epithelial, sarcomatous, biphasic).
- Mineralogical analysis of lung tissue for asbestos fiber identification (tremolite, actinolite).
- Ultrastructural examination of tumor tissue.
Main Results:
- Eighty-two percent of MM cases (41/50) were epithelial, 14% sarcomatous (7/50), and 14% biphasic (7/50).
- Mineralogical analysis revealed high concentrations of asbestos fibers, primarily tremolite and actinolite, in lung tissues.
- Ultrastructural findings confirmed asbestos fibers within lung interstitial cells.
Conclusions:
- Environmental asbestos inhalation is a significant public health issue in parts of Turkey.
- Contaminated soil may be a primary source of asbestos exposure leading to malignant mesothelioma.
- Further research is needed to understand the full impact of environmental asbestos on public health in the region.
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