| Environmental Malignant Mesothelioma in Southern Anatolia: A Study
of Fifty Cases E. Handan Zeren,1 Derya Gümürdülü,1 Victor L. Roggli,2 Ilhan Tuncer,1 Suzan Zorludemir,1 and Melek Erkisi3 1Department of Pathology, Çukurova University, Adana, Turkey; 2Duke University Medical Center, Durham, North Carolina, USA; 3Department of Oncology, Çukurova University, Adana, Turkey 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. Intersititial 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. Key words: actinolite, asbestos, EDXA, environmental malignant mesothelioma, southeastern Anatolia, tremolite, Turkey. Environ Health Perspect 108:1047-1050 (2000) . [Online 11 October 2000] http://ehpnet1.niehs.nih.gov/docs/2000/108p1047-1050zeren/ abstract.html Address correspondence to E.H. Zeren, Çukurova University, Faculty of Medicine, Department of Pathology, 01330 Adana, Turkey. Telephone: 90-322-225 2857. Fax: 90-322-338 6572. E-mail: hzeren@superonline.com This study was presented at the 87th Annual Meeting of United States and Canadian Academy of Pathology in Boston, Massachusetts, USA, on 28 February-6 March 1998 and won the "Best Pulmonary Poster Presentation Award" from the Pulmonary Pathology Society. Received 28 February 2000 ; accepted 9 June 2000.
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