Monday, August 24, 2009

Pathophysiology in Mesothelioma

The mesothelium consists of a single layer of flattened to cuboidal
cells forming the epithelial lining of the serous cavities of the body
including the peritoneal, pericardial and pleural cavities. Deposition
of asbestos fibres in the parenchyma of the lung may result in the
penetration of the visceral pleura from where the fibre can then be
carried to the pleural surface, thus leading to the development of
malignant mesothelial plaques. The processes leading to the
development of peritoneal mesothelioma remain unresolved, although it
has been proposed that asbestos fibres from the lung are transported
to the abdomen and associated organs via the lymphatic system.
Additionally, asbestos fibres may be deposited in the gut after
ingestion of sputum contaminated with asbestos fibres.

Pleural contamination with asbestos or other mineral fibres has been
shown to cause cancer. Long thin asbestos fibers (blue asbestos,
amphibole fibers) are more potent carcinogens than "feathery fibers"
(chrysotile or white asbestos fibers). However, there is now evidence
that smaller particles may be more dangerous than the larger
fibers.They remain suspended in the air where they can be inhaled, and
may penetrate more easily and deeper into the lungs. "We probably will
find out a lot more about the health aspects of asbestos from [the
World Trade Center attack], unfortunately," said Dr. Alan Fein, chief
of pulmonary and critical-care medicine at North Shore-Long Island
Jewish Health System. Dr. Fein has treated several patients for "World
Trade Center syndrome" or respiratory ailments from brief exposures of
only a day or two near the collapsed buildings.

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