title: Malignant mesothelioma following treatment for Hodgkin's disease.
abstract: OBJECTIVE
  Asbestos exposure is the major known risk factor for mesothelioma, but several case reports have suggested a link between radiation therapy and subsequent development of malignant mesothelioma. This report explores a possible association between radiation therapy for Hodgkin's disease and mesothelioma.
  
  
  METHODS
  Four cases of malignant mesothelioma were observed following Hodgkin's disease at the Mesothelioma Clinic of the Dana-Farber Cancer Institute. A fifth such patient was found after a review of the literature.
  
  
  RESULTS
  In all five cases, the mesothelioma arose in the field of prior radiotherapy. No history of asbestos exposure was elicited by careful questioning or by review of chest radiographs. Examination of lung tissue in one patient showed 250 ferruginous bodies per gram of lung tissue, consistent with no significant prior exposure. The mean interval between radiation treatment for Hodgkin's disease and development of mesothelioma was 15 years, which emphasizes the need for continued follow-up and evaluation of these patients and supports a causal relationship.
  
  
  CONCLUSIONS
  Mesothelioma may need to be added to the list of second malignancies that arise following radiation therapy for Hodgkin's disease. Further support is given to a causal link between radiation exposure and mesothelioma.
authors.affiliation: Department of Medicine, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: L B
authors.initials: LB
authors.lastname: Weissmann
authors.forename: J M
authors.initials: JM
authors.lastname: Corson
authors.forename: A I
authors.initials: AI
authors.lastname: Neugut
authors.forename: K H
authors.initials: KH
authors.lastname: Antman
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000209:etiology*; D009381:Neoplasms, Radiation-Induced; D010534:Peritoneal Neoplasms / Q000209:etiology; D010997:Pleural Neoplasms / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects