The Doubters and the Role of Other Forms of Asbestos

It seems that every advance of science has its skeptics, who are drawn along screaming and kicking. Schepers Garrett (76), then working as American pathologist, was a native of southern Africa. He talked about his own experiences at the Academy of Sciences of New York for the meeting: 


As a child, I lived near Kuruman in a number of years. It was impossible to imagine a healthier territory. However, there is a particularly troublesome type of grass in the area (Klitsgras), whose seeds are buried in each garment to cling to, as these seeds are armed with small teeth. Of course, when the wind blows, as often happens in Kuruman, some of these tiny barbs can be inhaled. I wonder if some of these structures occur in people with lung fiber in this field can not represent the reaction of the barbules grass. I suggest that this theory Klitsgras mesotheliomatosis Kuruman, to remove the obstacle created by the discovery of this rare disease in the abundance of such people with so little significant exposure to asbestos. Perhaps the South African pathologists will now turn to mince my theory. [P. 599] 


          Also at this meeting Schepers, said: 


My first impression of what is now less certain that the inhalation of asbestos is associated with lung tumors that 10 or 20 years ago. This is probably due to exposure to dust significantly reduced. Asbestos can become carcinogenic only at doses be overwhelming. Therefore, the high prevalence of malignancy was reported several decades ago may be a function of the severity of impact, and not an indicator of high carcinogenic 
potency. I suspect that over time the carcinogenicity of asbestos is estimated to be of lower order. Perhaps the carcinogenicity of asbestosis are correlated, but no specific biological functions of asbestos ore. This may be the point. In all cases of lung cancer associated with asbestos, which I personally have studied (the number now exceeds two dozen), has always developed asbestosis. Not only that asbestosis marked as areas where the cancer arose, but in general there is no evidence of serial chest X-ray that asbestosis was present in the lungs for a long period. [P. 595] 


          Ian Webster (77), JC Wagner who was the brother-in-law and a pulmonary pathologist wellrespected still says there are unresolved problems in the relationship between asbestos and malignant tumors in the document published in February 1973 in South African Medical Journal. Webster was skeptical as to why he had a rare tumor, it seems, can be found mostly in direct relation to exposure to crocidolite. Webster suggests that other factors, perhaps the mineral must be present to explain the high incidence of mesothelioma is a very localized area of ​​South Africa. He looked at asbestos exposure and association with 232 cases of pleural mesothelioma. Almost all people who were exposed to asbestos blue layer, only two miners exposed to amosite, as can be discerned. Thirty-two cases have occurred when there was no evidence of exposure to asbestos, it is anticipated that the environmental impact. There were only two cases involving exposure to amosite of the 232 confirmed cases of mesothelioma. He said: "It is also difficult to imagine in the middle group, amosite asbestos fibers cause malignant tumors, as suggested by Wagner and others, when there are so few cases, employees of amosite mines." He will say, "were the production of asbestos amosite much larger than the blue of the Cape. It is assumed that more attention should be paid to defining the nature of matter Cape blue areas and not in the Transvaal and blue and, obviously, limited to areas where amosite is removed. " The same view was offered before, in 1969, George Wright (78), one of the most respected researchers in the United States, the professional pulmonary 
disease, which in his opinion, "Asbestos and Health in 1969," said: "This is something other than or in addition to asbestos plays a role in the formation of mesothelioma seems inevitable." Wright of asbestos to cause mesothelioma, but I felt it was "permissible level of asbestos fibers into the air, that does not involve undue risk of mesothelioma." Later, states that "an acceptable level was essential."

Readmore »» The Doubters and the Role of Other Forms of Asbestos

Association and Causation, 1960 to 1973

Also in 1960, Keal (56) reviewed the records and found the English Hospital 23 women with asbestosis. Four of them were without known primary peritoneal carcinomatosis, an ovarian cancer and four
others had a peritoneal malignancy, possibly of ovarian origin. Along with asbestosis outrageous, but the relationship between asbestos exposure and peritoneal malignant diseases were urged to 4 years. Winslow Taylor and (57) published a series of 12 cases of peritoneal mesothelioma in 1960 and reviewed 13 cases previously reported in the literature. No association with exposure to asbestos has been mentioned in his work. However, the relationship between asbestos exposure and diffuse abdominal tumor was established in the English literature paper and Enticknap Smither (58) in 1964. And in this case the Germans a link between exposure to asbestos, and this is a rare tumor before other researchers. Despite attempts to define tumor mesothelioma have been made by earlier investigators, as Klemperer and Rabin (23) in 1931, there was general agreement among pathologists that an organization really existed. In 1957, Godwin (44) published strict criteria for the diagnosis of pleural mesothelioma, which places a pathological identification on a firm scientific basis. It was not until 1960 that Winslow Taylor and did the same for tumors of peritoneal mesothelioma. After the opening of the association of Wagner, from Cabo de blue crocidolite
asbestos and an increased risk of mesothelioma in South Africa, the question arose whether this was the only problem is limited to South Africa, or if it was a problem that has arisen in the United States
States. The American Medical Association Council on Occupational Health (59) published an article in the Archives of Environmental Health of pneumoconiosis in 1963, which has a section on asbestosis.
The expert panel concluded that:


The relationship between lung cancer and asbestosis is a highly topical issue. There is no doubt that the two diseases appear in the same light. No matter what the event is a coincidence,
or a cause-effect relationship can not be resolved on the basis of a case. The bulk of the evidence supports the relationship, especially when it includes certain types of asbestos, and possibly only those that contain certain chemicals have the ability to cause cancer. Attention is drawn to the experience of the Union of South Africa, where they have pleural mesothelioma in a significant number of people exposed to crocidolite amosite asbestos inhalation. Of course, clinical and experimental epidemiological studies needed for the final solution.
[P. 37]
In 1962, Wagner (60) was capable of producing tumors of the pleura mesothelial direct implantation of asbestos dust in laboratory animals. In 1963, Wagner said that in the 14 International Congress on Occupational Health in 120 cases of mesothelioma, but, interestingly, less than half of the patients worked directly with asbestos, which only live in an area where there is no environmental impact. So the question was whether it was a localized group of patients with mesothelioma, or a precursor to the international epidemic. This question has been answered at the International Meeting on the biological effects of asbestos took place at the Academy of Sciences of New York in New York in October 1964 but not published until December 31, 1965 (61). Reports of a meeting in New York with Newhouse and Thompson, in London, Ireland Elmes and Wade, James, and Anspach in Germany, Hammond, Selikoff and Churg in the United States and Viliani and colleagues in Italy confirmed the overall size of problem.
Selikoff and others (62) reported their experience with the relationship between asbestos exposure and mesothelioma in the New England Journal of Medicine in 1965, further cementing the relationship between asbestos exposure and mesothelioma and the question of whether other types Asbestos can cause mesothelioma. The authors do not believe that American workers had significant exposure to crocidolite. They thought that the occurrence of mesothelioma in a cohort of asbestos insulation are chrysotile and amosite, mainly. All patients had a severe exposure and asbestosis. This article was then an editorial in the New England Journal of Medicine March 18, 1965 (63). Editorial says that the amosite, a third type of asbestos used commercially, has not yet been charged, but no definitive studies to date, to confirm or refute an association.
Sluis-Cremer (64) of the Medical Office of the miner in Johannesburg, South Africa, spoke at the Academy of Sciences of New York in 1965. Sluis-Cremer in his discussion of mesothelioma, said that epidemiological studies have shown that mesothelioma only in the northwest Cape of South Africa. Transvaal amosite deposits have been actively developing more time passes, said that in 1940 amosite was carried out at three times the amount of crocidolite northwest, but no mesotheliomas were observed in the northwest associated with exposure to amosite.
Of particular interest was the study of cases and controls in the Newhouse and Thompson (65). We diagnosed 83 patients, 41 men and 43 women with mesothelioma due to asbestos-point plant blue, which opened in London in 1913. There were 27 peritoneal and 56 pleural tumors, tumors. The plant uses crocidolite out exclusively until 1926, when a small amount of amosite and chrysotile were added. Eighteen patients were employed at the factory, and eight of asbestos as insulation
and laggards. Another nine patients had a house with asbestos workers. Particularly worrisome was the discovery of 36 patients with no known work or exposure to asbestos at home. Eleven of these patients live a half mile from the factory of asbestos exposure in the event area. This case-control study and Elmes et al (66) were the first two case-control studies to confirm the previous report of Wagner from South Africa. Concerns about the impact of the neighborhood and was seconded by Lieben Pistawka (67) of the Pennsylvania Department of Health, which reported that of 42 patients with mesothelioma, 20 had occupational exposure only eight living in the vicinity of the asbestos factory, exposure and three were relatives.
The medical society as a whole believes that if asbestosis could be avoided by reducing exposure to friable asbestos, malignant asbestos should also be avoided. The first cases of mesothelioma are generally very susceptible to early 1900 before taking action to combat dust. Selikoff (68) stated in 1969: "I have not seen the mesothelioma in man, who began working after 1930, or the case of lung cancer in asbestos workers who worked in the industry, less than twenty years . " However, the data of Wagner, Newhouse and Thompson, Lieben and others challenged. Thompson (69.70) reported in 1963 by organs of asbestos in the lungs of people who do not work with asbestos and called him a danger to the modern city.
In 1968 Utidjian et al (71) reported that almost 100% of urban residents had asbestos bodies in their lungs. In 1970, the original observations were confirmed Thompson extensively in Montreal, Milan, London, Newcastle, Glasgow, Belfast, Dresden, Pittsburgh, Miami and New York (68). Paradigm has occurred, in 1970 it was generally agreed that low-level exposure in northwestern Cape blue crocidolite was capable of causing mesothelioma. In 1966, imports of crocidolite asbestos was voluntarily abandoned in England, and the adoption of new rules for the relationship between asbestos and mesothelioma asbestos were adopted in 1969. For exposure to asbestos in the United Kingdom was set at 0.2f/mL (F is the degree of fineness of the abrasive particles) to crocidolite or a tenth of an acceptable level of exposure to other forms of commercial asbestos 2f / mL (72). The question remains, how much impact too. The next 30 years focused on the role of other types of commercial
asbestos and asbestiform materials. Wagner and Berry (73) to 1969 have been improved in animal models, which will help answer many of these issues. Stanton and the key (74) showed in 1972 that the carcinogenicity of asbestos has been linked to
diameter and length.
In 1965, Sir Bradford Hill (75) proposes criteria for assessing the causality of chronic diseases. His seminal work presented at the Royal Society of Medicine, provides a systematic approach to assess the relationship between asbestos exposure and mesothelioma. The main requirements were the strength of association, consistency of association, dose-response relationship and biological plausibility. The adoption of new ideas is slow. Biological plausibility of carcinogenesis is mainly intended to rely on animal models and tissue cells or by analogy to other types of human cancer. Unfortunately, the biological plausibility for many in the 1960's and early 1970 meant that if I can not understand, I do not think so.

Readmore »» Association and Causation, 1960 to 1973

Definition and Suspicion, 1943 to 1960

In the confusion that mesothelioma was a person really separateclinical had five different opinions on whether the source ofThe tumor:
(1) aberrant nest was malignant lung epithelial
      in the lining of the pleura;
(2) the endothelial lining of subpleural lymph was the source of the tumor, thus
      nameendothelioma;
(3) The tumor originated in the pleural capillary endothelium
      or subpleural lymphatic endothelium, or both;
(4) The tumor arose from the mesothelial layer of the pleura itself, or a mesothelial origin
      tumor or mesothelioma;
(5) the epithelial origin of these tumors have sprung from the primary tumor to other places
      metastasis to the pleura. These primary tumors can be small enough to easily
      lost in a normal autopsy. A sarcoma
      important subpleural tissue. It is due to differences of opinion
      the origin of the tumor, which was like a large number of terms used to describe
      the same process.
          In these circumstances, the confusion, the first reports began to filter some patients with asbestosis developed an unusual form of pleural malignancy. The first report was by Wedler (33), who reported the results of 30 autopsies of asbestos workers in Germany. He dropped one case, and the remaining 29 autopsies, four bronchial cancer, and two were malignant pleural growth. He commented on his impression that the incidence of cancer, which is 20% of all malignancies in this population was too high to be a coincidence, and lung cancer associated with exposure to asbestos. He reviewed all known research at that time, noting that the first mention of lung cancer associated with asbestosis was made in 1933 Gloyne (34), who said. "There was also a case of squamous cell cancer of the pleura There is no evidence at this time it was in any case
associated with asbestosis. "In 1935 Gloyne (35) was able to report two patients with lung cancer and asbestosis. Wedler not discuss whether the cancer was detected true pleural mesothelioma or have been associated with primary lung cancer, simply told the results and called a pleural proliferation of epithelial origin. He said that lung cancer was the most common complication in cases of asbestosis.
          Although the report was quickly accepted Wedler in Germany, the information is generally ignored elsewhere. In retrospect, Harrington (36), said: "Of particular interest is the apparent influence of politics, as previously published reports are from Nazi Germany, therefore, has received less attention and credibility that they should also there is skepticism seems natural.
And do not discriminate, by many observers scientific principles in the United States and Britain. "In 1947, a patient with pleural and pericardial mesothelioma, who worked with asbestos cardboard cut insulation was reported as chronic pulmonary congestion (CPC) at the Massachusetts General Hospital, but the association with asbestos was not adopted (37) . In 1952, Cartier (38) reported in the scientific meeting in the summary of the discussion, Smith seven cases of respiratory cancer in 4000 asbestos workers in the production of Quebec chrysotile industry and processing as well as
included in the cohort were two cases of pleural mesothelioma. Cartier thought that since the two cases is the asbestosis mesothelioma, the causality of exposure to asbestos can not be done. The details of these cases were not published.
          A year later, in 1953, Weiss (39) adds a third case of the two malignant tumors of the pleura is described by Wedler, that men with asbestosis and pleural mesothelioma, which did work in isolation from the Naval Shipyard 1920 to 1935. Weiss believes that the relationship between asbestosis and pleural mesothelioma was strong, and it is recommended that the German government to take it as a work-related condition. Von Rokitansky (40) in 1854 described the so-called primary peritoneal cancer, which he called "mucinous carcinoma". Although this tumor has been reported in English literature, first and Wynn Miller (15) in 1908, the relationship between the peritoneal tumor and possible exposure to asbestos was not until 1954, when another German, Leichner (41) described the autopsy done 2 years back to 53-year-old who worked in the asbestos plant first as an accountant. Leichner said the patient had asbestosis and tuberculosis, but the location of peritoneal mesothelioma seemingly at random. Leichner found evidence of asbestos fibers into the tumor, and felt again, peritoneal mesothelioma related work. Ashort later, in 1955, Bonser and others (42) reported 72 patients with asbestosis autopsies of which four were abdominal tumors are in agreement with peritoneal mesothelioma, but the authors never made the association that had peritoneal mesothelioma asbestosinduced.
          In 1956, Ackerman (43) wrote the majority opinion that the primary mesothelioma are rare but do exist. A year later, in 1957, Godwin (44) has written a very important article, which established strict diagnostic criteria for the diagnosis of pleural mesothelioma. In 1958, van der Schoot (45) reported two mesothelioma in insulation workers.
          In 1958, McCaughey (46) of Belfast, Ireland, 11 reported diffuse pleural mesothelioma and two located. He estimated that the strong evidence supporting the view that diffuse pleural mesothelioma clinical entity, despite opposition to this idea. He did not make the association in this study, asbestos, but does so in retrospect a year later (47). This article was a response to an article published intelligent and Hinson (48) of the London Chest Hospital, which reported 24 cases of pleural tumors and concluded that the appearance of true neoplasms of the pleura could not deny that the injury is the primary known, and there is no need to postulate the origin of this site (49). In 1956, Eisenstadt (50), Port Arthur, Texas, reported a patient who worked at the refinery, which has developed a malignant pleural mesothelioma, apparently. Experienced pathologists noted that denied the existence of a tumor, but felt the need for this report in any way.
          A good example of the confusion of what to do with the diagnosis of mesothelioma negotiation, Sir Richard Doll (51) in his classic 1955 study of the connection between lung cancer and asbestosis. In Table II, in a paper describing 15 patients with asbestosis and certain lung cancers, but uses only 11 of 15 in their analysis. Two patients are reported as well endothelioma of the pleura or epithelial carcinoma. Three other patients with lung cancer is detected, but did not have asbestosis. The link between asbestos exposure and pleural endothelioma was made, and, apparently, was excluded from statistical analysis.
          Year crucial to establish the link between asbestos exposure and mesothelioma in 1960. Is the fundamental work of Wagner et al (52), entitled "Diffuse pleural mesothelioma and asbestos exposure in northwestern Cape Providence." This document has been controversial, as described 33 cases of diffuse pleural mesothelioma when exposed to only one type of asbestos, blue asbestos called Cape mined in the hills of asbestos in the west Kimberley, northwest of Cape Providence, South Africa. Wagner and others said the tumor is rarely found elsewhere in southern Africa. This means that the tumor seemed to be very specific to a particular geographical area or a specific type of crocidolite. Data were considered suspects pathologists, many that only four of the patients had a complete autopsy, and the rest were simple pleural biopsy, were considered by many to be unreliable for the diagnosis of mesothelioma. Another problem is that the previously reported cases of heavy industry exposure and asbestosis, as a rule, most of Wagner and others
cohort did not have asbestosis or exposure to heavy industry. The general consensus then was that the true diagnosis of mesothelioma could not be done if there is no complete autopsy, excluding
some primary tumors in other parts of the body, which were metastases in the pleura, and if there was also a concomitant asbestosis. The initial reaction was muted, as so eloquently stated Elliott McCaughey (53) due to "lack of evidence in experimental animals, denial or lack of knowledge about science conducted outside the United States, and the reluctance some writers to change their minds. " In an editorial article in South Africa in 1968, the relationship between exposure to crocidolite and mesothelioma is still considered unproven (54).
          In 1960, Eisenstadt and Wilson (55) published a paper describing two patients with pleural mesothelioma. The second patient was a long history of asbestos exposure, and no asbestos bodies in lung biopsy specimens. The authors consider the relationship between exposure to asbestos and the subsequent development of unusual pleural disease.

Readmore »» Definition and Suspicion, 1943 to 1960

Histologic Controversy 1900 to 1942

Miller and Wynn (15) were the first to suggest that peritoneal tumors may present features such as epithelial and embryonic fibroblasts of the relationship of these cells to
In 1924 (3) Article Robertson endothelioma of the pleura, probably the most comprehensive study of literature has been done before that time. At the time of this publication, or primary malignant pleural endotheliomas, of course, rarely is that Clarkson (17) in 1914, said the post-mortem examinations in 10 829 Munich, Germany, there were only two cases of primary endothelioma of the pleura, but could not find records of only 41 cases. Later
Robertson quotes Keilty (18), who reviewed the records of pathology at the University of Pennsylvania and found nine cases of primary endothelioma of the pleura in 5000 postmortem examinations.

Bayne-Jones (19) described a child 16 years of age with malignant pleural base, which Bayne-Jones thought he was the primary tumor cells lining the pleura and epithelial tumors, which he described as cancer of the pleura. Bayne-Jones believes that this tumor is not endothelioma or not arising from the lymphatic endothelium, but mesothelial cells and, therefore, was of epithelial carcinoma. In 1920, Du Bray and Rosson (20) proposed the term primary pleural mesothelioma. It is believed that the term pleural carcinoma, or endothelioma was not necessary, but the more appropriate term mesothelioma. In 1921, Eastwood, Martin (21) agreed that the term should be mesothelioma. Zeckwer (22) also uses the term mesothelioma in its report of 1928. The question of whether there is such thing as primary malignant endothelial originating from the pleura was discussed in detail by Robertson (3) in his seminal work, and rejected the idea that epithelial tumors of the mesothelium primary tumors thought These tumors tend to metastatic
Tumors of different origin. He thought the only sarcoma can be classified as primary malignant tumors, and all other types of growth of secondary tumors or metastases with implementations of the unrecognized, underlying malignant primary tumors in other locations. In 1931 Paul Klemperer and Rabin Coleman (23) published a report of five cases of the mountain. Sinai Hospital in New York, including one case in which the epithelial and mesenchymal characteristics. They thought that diffuse pleural tumors originated from the surface of the cells that line, mesothelium, and mesothelioma must be assigned, as suggested by others.
In 1933, S. Roodhouse Gloyne (24) considered it a number of cases of asbestosis, and said: "From the complications associated with asbestosis following were observed: (a) of abdominal cancer, (b) mitral stenosis, and (c) cerebral hemorrhage, and (g) of gallstone disease. There was a case of squamous cell cancer of the pleura. There is no evidence at present that it was in no way associated with asbestosis. "It is open to speculation about if they were the first cases of mesothelioma in workers exposed to asbestos!
Ewing (25) in 1940 expressed concern about the impact of chronic irritation or injury, and low grades of inflammation in the connective tissue changes occur in the pleura, and wondered if some of the cases of malignant pleural been associated with tuberculosis. Many of the previously reported cases had evidence of concomitant tuberculosis in several attacks of pleurisy the affected side. Chronic inflammation and injury as a cause of pleural changes were considered Ewing (25). Ewing's comments were reinforced excellent review of the literature and Aaron Andrea Saccone
Koblenz (26) of New York in 1943. The authors were able to identify 41 cases in seven series published between 1910 and 1938, the total number of 46 000 autopsies, or 0.09% of mesothelioma. They concluded their review of the case that some of these tumors have been misdiagnosed and have spread from other sites. Of course, the confusion in making a pathologic diagnosis will continue for many years. From 1960 to 1968, only half of the Canadian cases of mesothelioma in the death certificates can be confirmed by an expert panel (27).
Further evidence that these tumors originate in the mesothelium, rather than from the endothelium has been full and Murray (28) New York City in 1942. They used their research
tissue culture to support the idea that cancer cells are mainly due to mesothelial cells. His concept was so controversial histogenesis at the time his chief of pathology department requires them to publish a statement about his lack of faith in his paper.
Stoute later became a professor of pathology at Columbia University in New York. He was able to accumulate the pathological material of 156 mesothelioma in the period between July 1919 and June 1964. It was the largest series of one institution in the world in 1964 and in the same
Stout (29) later noted that, in retrospect, I know of a case associated with asbestosis.


Further confirmation of the theory of histogenesis Stout Postoloff came from Canada (30), entitled "pleural mesothelioma" which concluded that, in fact, mesothelioma can become malignant epithelial and sarcomatous both. He stressed the importance of the osteoid matrix on the histological features of mesothelioma. He also said his team found only seven consecutive autopsies mesothelioma 7878 for a period of 20 years between 1923 and 1942.
In 1946, Arnold Platt (31), a radiologist at the hospital in Newark, consider the radiological aspects of primary mesothelioma or endothelioma of the pleura. At that time, more than 200 authors have discussed and offered views on the essence of what is called at the time of primary mesothelioma or endothelioma of the pleura. Platt said that this was a very difficult diagnostic problem for pathologists, they questioned among
themselves as the type and origin of the tumor histology. At that time there were more than 30 different terms used to describe this clinical entity, including endothelioma, mesothelioma, cancer of endothelial cancer, pleural, primary papillary endothelioma of the pleura, adenoendothelioma, sarcoendothelioma, pleural Kaposi sarcoma, all cells spindle sarcoma, angiosarcoma, lipomyxosarcoma, giant sarcoma visceral pleura, sarcomatous malignant disease of the pleura, malignant tumors of the pleura, the mesothelial cell carcinoma, perithelioma, endothelioma, carcinomatodes,
lymphangioendothelioma, fibroendotheliosis pleura, proliferans lymphangitis, pleuroma, abdominal swelling and colloid tuberculosis, as lymphadenoma (32).

Readmore »» Histologic Controversy 1900 to 1942

Early Discovery 1767 to 1900

The history of the term mesothelioma has entailed more than 100 years of controversy. The earliest mention of a possible tumor of the chest wall was by Joseph Lieutaud (1), generally regarded as the founder of pathologic anatomy in France according to Wolf (2), as quoted by Robertson (3). Lieutaud published a study of 3000 autopsies, among which were two cases of “pleural tumors.” The published account mentions a boy who suffered from marked dyspnea following trauma, who at postmortem showed fleshy masses adherent to the pleura and the ribs. Laennec (4) in 1819 is also said by Robertson to have suggested that there was an entity of primary malignancy of the pleura based on

Table 1.1. Important historical events between 1767 and 1972

Year	Researcher	Event
1767	Lietaud	Report of first possible case of pleural mesothelioma
1854	Von Rokitansky	First pathologic description of peritoneal mesothelioma
1870	Wagner mesothelioma	First pathologic description of pleural
1890	Biggs	First American case
1920	Du Bray,	First use of the term mesothelioma
	Rosson
1924	Robertson	Best review of literature up to that time
1942	Stout, Murray	Further evidence on histogenesis
1953	Weiss	Association with pleural mesothelioma made in Germany
1954	Leichner	Association of asbestosis with peritoneal mesothelioma
1957	Godwin	Clear pathologic criteria for pleural mesothelioma
1960	Winslow, Taylor	Clear pathologic criteria for peritoneal mesothelioma
1960	Wagner	Mesothelioma associated with northwest Cape crocidolite
1964	Enticknap,	Association of asbestos and peritoneal mesothelioma
	Smither
1965	Selikoff	New York Academy of Science Symposium,
		report on U.S. insulators
1969	Wagner	Animal model further perfected
1972	Stanton, Wrench	Stanton hypothesis on the importance of fiber size/length

the epithelial nature of these pleural cells. In 1843, von Rokitansky (5) actively opposed the idea of primary cancer of the pleura, and stated that pleural cancer always was secondary to a primary focus elsewhere. Ironically von Rokitansky in 1854 described what were called primary tumors of the peritoneum, which he called “colloid cancer” and most likely were peritoneal mesotheliomas. This strong opinion on the metastatic origin of pleural mesotheliomas by the German pathologists was to remain the opinion of many pathologists up through the mid- 20th century as stated by Willis (6). There were further reports in the early 19th century of what could be considered pleural-based cancers. It was Wagner in 1870 who first described a lesion, which he classified as “Das Tuberkelähnliche Lymphadenom.” He felt this was a primary malignancy of the pleura in a 69-year-old woman in whom an epithelial-based malignancy was found. Wagner had described lymph channels filled with tumor. Schultz (7) in 1875 reexamined the preparations of Wagner and emphasized the neoplastic nature of the process and renamed it endothelial cancer. The tumor was thought to arise from the lymph vessels and was commonly called an endothelioma. This was not questioned until 1891, when Engelbach (8) first raised the question of whether these tumors arose from the endothelium of the lymph vessels or from the surrounding serosal surfaces.

During the late 19th century and early 20th century, there was general acceptance that some sarcomas arose from the pleura when there was no evidence of a primary elsewhere, and it was generally accepted that the only tumor that might be primary to the pleura orthe subpleura was a primary sarcoma. This was generally the Italian view as summarized by De Renzi (9). In 1890 Biggs (10) was the first American to report two cases of “endothelioma of the pleura” at the New York Pathological Society. Primary fibrous sarcomas of the pleura were generally accepted as arising from the fibroblast but not the pleural tissue itself. The fact that the pleural lining was capable of producing tumors that were both epithelial and of connective tissue origin was first pointed out by Paltauf (11), Borst (12), and Kaufmann (13). By 1909 Patterson (14) found 96 cases in the literature and added twoof his own. The disease occurred twice as frequently in men than in women, and the greatest number of cases was found in patients between the ages of 40 and 60 years.

Readmore »» Early Discovery 1767 to 1900

The History of Mesothelioma

History of the discovery of this rare tumor and the subsequent controversy arose about its causation by specific forms of long and complex commercial asbestos. You could fill a book. This chapter focuses on the early history of discovery, from 1767 to 1900, for histological controversy, between 1900 and 1942, and the differences in diagnosis and asbestos paper from 1943 to 1973 (Table 1.1).
From 1972 to 1980 and 1990 can be characterized by achievements in the field of industrial hygiene, exposure assessment, case-control studies, and other large epidemiological studies on health effects of asbestos to the end user of products, exhibitions paraoccupational, effects of home, school construction and exposure, and the role of certain types of asbestos fibers, fiber characteristics and fiber easy loading analiza.1970 's of the 1990s was a period when the role of environmental impact erionite, tremolite and ceramic fibers was found, and molecular and cell biology focused on the carcinogenic fiber characteristics. In the last period, from late 1990 to present, emphasized the contribution to the pathogenesis of viral genetics SV40 and human rights, and treatment strategies.

Readmore »» The History of Mesothelioma

Preface

Malignant mesothelioma is a malignant cancer sentinel. It's amazing how fast natural history with a median survival of 6 to 8 months, when untreated, is the environment related to such economic and social consequences that lawyers specialize in representing mesothelioma patients only. The experts to devote all his time to testify, and governments are forced to consider not only the prohibition of the environmental agent, but re-evaluate the entire compensation system for victims tort victims. Furthermore, its presence in some populations has changed the mentality of an entire community, such as Libby, Montana, Cappadocia, Turkey, and Sarnia Ontario.
          Because of their rarity, malignant mesothelioma is considered an orphan disease and managed anecdotally, in practice most of the cancer. However, this disease has created new scientific paradigm in the clinic, laboratory, and the community.
          This blog was created to correct the information of "disengagement" orphan disease and create awareness among scientists around the world on the new concepts of molecular genetics, epidemiology and carcinogenesis of mesothelioma. We, as editors and writers working to raise awareness about mesothelioma and reverse a disproportionately low number of R & D funding for the study of this type of cancer. We also believe that the study of this fascinating disease, occurring in the context of judicial matters must go through the same way that all science is in the path of discovery. Legal issues should have no effect, but, unfortunately, often in areas of science and medicine.
          In the past decade, evidence has accumulated that the cancer of mesothelioma caused by asbestos and erionite environmental carcinogens that interact with genetic predisposition, and viral infections during cardinogenesis. The result of these complex interactions determine which of exposed individuals develop cancer. On the other hand, mesothelioma has become an ideal model to study how genetic and viral infections, environmental impact of carcinogenesis, and to discover new targets for early diagnosis and therapy.
          Not only cancer caused as much controversy as mesothelioma. More than 40 years scientists have debated whether chrysotile asbestos causes mesothelioma or not. As if the dispute is not played enough chrysotile, new developments in the field of mesothelioma, where two of the editors of this blog (HP and Microsoft) reported that DNA tumor virus SV-40 that causes mesothelioma in animals, was present in some human mesothelioma. In addition to these important questions of causality, the conflict that exists regarding the best surgical treatment of diseases and the interpretation of the novel test for mesothelioma. All these issues volatile, even economic, legal, and most importantly, the scientific aspects discussed in various chapters of this blog. We recommend the reader not only to digest these issues, but they are the contradictions in mesothelioma promising as new data is entered.
          Distribution of specific knowledge of mesothelioma has led to an increase in the number of international conferences about mesothelioma, where scientists presented new and interesting results. Mesothelioma Asufficient number of specific research is strong and is no longer the stepchild of the meetings devoted to lung cancer and sarcoma. Doctors and scientists, as currently defined as a "mesothelioma expert", and advice to prevent and detect the disease early and to treat diseases that currently sought not only to other doctors, but a growing number of E- mail directly from patients and their families.
          The editors provided a complete text that describes the contradictions and facts in order to raise awareness about the epidemic of mesothelioma and how to help doctors and scientists in their efforts by the bank, or cure diseases or to develop new therapeutic options. The complexity of mesothelioma have only recently been implemented, and this complexity requires that the disease "graduate" from a chapter in the text of oncology. Therefore, this blog is intended to be used as an authoritative guide for doctors, primary care physicians, pulmonologists, medical oncologists, radiation oncologists and surgical oncologists as well as children in education in these straits. Moreover, due to the economy and the legal effects of mesothelioma, this blog will have a significant impact in the courts of general jurisdiction.
          It was a truly international effort, and North America, Europe, Middle East and Australia, the prospects for clinical and translational aspects of mesothelioma are presented. This fact in itself increases the overall character of the light of the epidemic, and emphasizes that the source of background information that could be expanded in future editions should be running at this time. The editors thank all the authors who took time from their busy schedules to contribute to this first attempt. His enthusiasm and patience in providing the latest information about their areas of expertise are reflected in their chapters and the editors hope their efforts will be rewarded with a new generation of oncologists and researchers who will be treated with knowledge of mesothelioma rather than apathy. Finally, the editors want to thank for the fact that the foresight to recognize the Springer gap in the literature about mesothelioma, the publication of this blog. As he approached the first editor of this project, there was no indication the market is too small or the population in favor or supporting the project, and Springer was the genuine colleague in this endeavor. Special thanks to Beth Campbell, Stephanie Saxon, Chernov Barbara, Brian and Laura Gillan Drozda diZerega, all of which was this effort with the unconditional support.

Readmore »» Preface