The mesothelium consists of a single layer of floored to cuboidal cells shaping the epithelial lining of the serous cavities of the body encompassing the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may effect in the penetration of the visceral pleura from where the fibber can thereafter be carried to the pleural surface, therefore spearheading to the growth of malignant mesothelial plaques. The processes spearheading to the growth of peritoneal mesothelioma remain unresolved, however it has been intended that asbestos fibres from the lung are shipped to the abdomen and related organs by mechanism of the lymphatic system. Additionally, asbestos fibres may be deposited in the gut afterwards ingestion of sputum infected with asbestos fibres.

Pleural infection with asbestos or other mineral fibres has been shown to activate cancer. Long lean asbestos fibres (blue asbestos, amphibole fibres) are more potent carcinogens than "feathery fibres" (chrysotile or white asbestos fibres). However, there is now evidence that lower particles may be more deadly than the bigger fibres. They remain suspended in the atmosphere where they can be inhaled, and may penetrate more simply and deeper into the lungs. "We possibly shall discover a lot more approximate the medical 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 a figure of patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of merely a day or pair near the dilapidated buildings.

Mesothelioma growth in rats has been indicated chasing intra-pleural inoculation of phosphorylated chrysotile fibres. It has been advised that in humans, transportation of fibres to the pleura is severe to the pathogenesis of mesothelioma. This is advocated via the noticed recruitment of important figures of macrophages and other cells of the immune system to local lesions of gathered asbestos fibres in the pleural and peritoneal cavities of rats. These lesions lasted to attract and gather macrophages as the infection progressed, and cellular adjustments within the lesion culminated in a morphologically malignant tumor.

Experimental evidence advises that asbestos acts as a accomplish carcinogen with the growth of mesothelioma occurring in sequential phases of initiation and promotion. The molecular mechanisms underlying the malignant revolution of regular mesothelial cells via asbestos fibres remain faint regardless the example of its oncogenic capacities (see next-but-one paragraph). However, accomplish in vitro revolution of regular human mesothelial cells to malignant phenotype chasing exposure to asbestos fibres has not yet been achieved. In overall, asbestos fibres are thought to behave through guide physical interactions with the cells of the mesothelium in conjunction with indirect impressions chasing interaction with inflammatory cells such as macrophages.

Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to produce contact with chromosomes, frequently attaching to the chromatin fibres or becoming embroiled within the chromosome. This contact between the asbestos fibber and the chromosomes or structural proteins of the spindle device can induce complex abnormalities. The majority frequent abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.