Which thoracic malignancy is strongly linked to asbestos exposure?

• A. Small Cell CA
• B. Large Cell CA
• C. Adenocarcinoma
• D. Mesothelioma

Answer: (D)

Asbestos exposure is classic for mesothelioma, a cancer that originates from mesothelial cells lining the pleura (and sometimes the peritoneum). Inhaled asbestos fibers lodge in the pleural space and provoke chronic inflammation and repeated injury over many years, leading to malignant transformation of mesothelial cells. The latency period is long, often several decades, which is a hallmark of this disease. Clinically, mesothelioma often presents with chest pain and shortness of breath due to pleural effusion and thickening, and imaging may show pleural plaques or diffuse pleural involvement. Among thoracic malignancies, this is the strongest, most well-known link to asbestos exposure. Other lung cancers—like those arising from the airways—are more strongly tied to smoking and other factors; asbestos can increase lung cancer risk, but the distinct association emphasized in exams is with mesothelioma.