Role of asbestos and other fibres in the development of diffuse malignant mesothelioma.

Descriptions of diffuse malignant mesothelioma date from the nineteenth century' but it was not until 1960 that Wagner et al2 described a series of cases of pleural mesothelioma from South Africa and linked them to crocidolite asbestos exposure. Malignant mesotheliomas may arise from the pleura, peritoneum, and pericardium and all may be associated with asbestos exposure. Malignant mesothelioma of the pleura should be distinguished from the so called localised pleural mesothelioma (pleural fibroma), which is rarely malignant3 and which is not associated with asbestos exposure. Malignant mesothe- lioma is an uncommon tumour with an annual male incidence of 7-13/1 000 000 and a female incidence of 1-2/ 1 000 000 in the United States.4 In Great Britain the death rate (equivalent to the incidence) in 1983 was 17 5/ 1 000 000 for men and 3 2/1 000 000 for women.5 The