The clinical and radiological aspects of 185 cases of malignant pleural mesothelioma.

One hundred and eight-five cases of environmentally-caused malignant pleural mesothelioma were analysed for clinical and radiological pictures. The first group consisted of 122 subjects from villages with asbestos deposits. The second group consisted of 63 patients from the Cappadocia region where there are no asbestos deposits but where zeolite occurs. The mean age at death and the age range of the patients were lower than those of patients with occupationally-caused mesothelioma. This can be explained by the fact that exposure to mineral fibres in Turkey begins immediately after birth. The mode of onset was insidious chest pain, and the mean interval before reaching hospital was six months. The average duration of illness from the onset of symptoms to death was nearly 18 months. The most common clinical findings were evidence of pleural effusion and thickening. Bronchial breathing, tumour extension to the chest wall and frozen chest were also observed. Horner's syndrome was recorded in seven cases, and hypoglycaemia features in two. Pleural effusions and thickening, nodular and lobular lesions in the pleura, calcified pleural plaques with pleural lesions and hydropneumothorax were the radiological manifestations of malignant pleural mesothelioma. Three patients with mesothelioma were being followed up after a diagnosis of asbestos-caused pleurisy.