Original ArticlesMalignant Diffuse Mesothelioma in Women A Study of 354 CasesPavlisko, Elizabeth N. MD*; Liu, Beiyu PhD†; Green, Cindy PhD†; Sporn, Thomas A. MD*; Roggli, Victor L. MD*Author Information *Department of Pathology, Duke University Hospital †Department of Biostatistics & Bioinformatics, Duke University, Durham, NC Conflicts of Interest and Source of Funding: V.L.R. and T.A.S. have served as expert witnesses for asbestos litigation. The remaining authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Elizabeth N. Pavlisko, MD, Duke University Medical Center, DUMC 3712, Durham, NC 27710 (e-mail: email@example.com). Online date: December 23, 2019 The American Journal of Surgical Pathology: March 2020 - Volume 44 - Issue 3 - p 293-304 doi: 10.1097/PAS.0000000000001418 Buy Metrics Abstract We reviewed 354 cases of malignant diffuse mesothelioma (MM) in women from a database of 2858 histologically confirmed MM cases. There was a pleural predominance with 78% pleural MM and 22% peritoneal MM. The pleural tumors consisted of 72% epithelioid, 19% biphasic, and 9% sarcomatoid variant. The peritoneal tumors consisted of 82% epithelioid, 13% biphasic, and 5% sarcomatoid. The immunohistochemical profile was typical of what is well-accepted and previously described for MM. When examining tumor subtype and location, there was a trend toward epithelioid subtype and peritoneal location; however, this did not reach statistical significance. Age at the time of diagnosis ranged from 19 to 93 years with a mean of 60 years. The median age at time of diagnosis for pleural MM was 65 years and for peritoneal MM was 52 years. A further look at age and histologic subtype showed no statistically significant difference in age between MM subtypes. Survival was greatest for epithelioid variant, and this was magnified in the peritoneum. A majority of our cases were exposed to asbestos through a household contact. Asbestosis and parietal pleural plaque were present in 5% and 50% of cases with data, respectively. Fiber analysis data was available in 67 cases; 38 cases had elevated asbestos fiber burden, and tremolite was the most common asbestos fiber type detected. Commercial and noncommercial amphibole asbestos fibers were elevated in nearly equal numbers of cases. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.