Previous studies demonstrated the hypoxic microenvironment of mesothelioma,21,22 and that LDH-A overexpression correlated with hypoxia in different solid tumours.41 In this study, 20 out of 33 MPM cases (60%) and 36 out of the 56 DMPM (64%) displayed high LDH-A expression. The gene discussed is LDHA; the disease is mesothelioma.