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.
