Epithelial, Sarcomatoid, and Biphasic Mesothelioma

There are three types of mesothelioma – epithelioid, sarcomatoid and biphasic. Each type differs in the type of cancerous cells that manifest in the protective lining of the internal organ. To determine which type of mesothelioma is present, a doctor will perform a biopsy. This involves removing a tissue sample from the affected area and viewing the cells under a microscope. Based on the shape of the mesothelioma cells, the specific type of mesothelioma can be diagnosed.

Epithelioid Mesothelioma

Epithelioid mesothelioma is the most common type of asbestos cancer. Approximately 50 to 70 percent of all mesothelioma cases are of this variety. Under a microscope, individual epithelioid cells are shaped like cubes. As a whole, the cells display a fairly uniform shape that aligns in a tubular pattern. They also exhibit a cell nucleus that is clearly defined and visible with the aid of a microscope.

The cell structure of epithelioid mesothelioma is similar to other diseases that manifest in the tissue lining. The most notable one is adenocarcinoma. Because of the similarities in cellular appearance, a misdiagnosis of epithelioid mesothelioma is not uncommon. For this reason, patients often seek the professional help of a specialized mesothelioma doctor. Furthermore, discussion of potential past exposure to asbestos is a critical preliminary discussion in the diagnosis process.

Sarcomatoid Mesothelioma

The least common type of mesothelioma is sarcomatoid. This variety is diagnosed in approximately 10 to 15 percent of all mesothelioma cases. In relation to epithelioid cancer cells, sarcomatoid cells feature a less uniform structure. Singular cells are more oval than they are cubed. Additionally, the nucleus of each cell is less distinct when viewed under a microscope.

Like epithelioid mesothelioma, sarcomatoid mesothelioma can be difficult to diagnose. This is because other disorders exhibit similar cell structures. For example, desoplastic mesothelioma, a sub-type of sarcomatoid mesothelioma, displays a rather innocuous appearance that may be dismissed as benign fibrous tissue. Pulmonary sarcomatoid carcinoma and sarcomatoid cancer are also frequently misdiagnosed in individuals who suffer from sarcomatoid mesothelioma. Again, seeking the guidance of a specialized mesothelioma professional is typically the preferred method of diagnosis for patients.

Biphasic Mesothelioma

Constituting between 20 and 40 percent of all mesothelioma cases, biphasic mesothelioma is the second-most prevalent form of the cancer. Unlike the more distinct cell structures of epithelioid and sarcomatoid mesothelioma, biphasic mesothelioma exhibits a more varied structure. In fact, biphasic mesothelioma is named as such because both epithelioid and sarcomatoid cells are present.

The structure of such intermingled cells can vary from one case to another. Sometimes, individual epithelioid and sarcomatoid cells mix together in true patchwork form. Other times, each type of cell assembles in larger clusters. Because of the combined nature of biphasic mesothelioma, extreme precision is again necessary in the diagnosis process. Specifically, cautious doctors might do well to examine more than one section of the cancerous tissue during biopsy. Such a tactic improves the chances of identifying both types of cancer cells.

Prior to the improved methods of diagnosis that are present today, biphasic mesothelioma was frequently misdiagnosed as either sarcomatoid or epithelioid mesothelioma.

Treating the Different Types of Mesothelioma

The treatment process is similar for all types of mesothelioma. However, the rate of survival and expected survival time varies from one type to another. Epithelioid mesothelioma offers the best chances for survival. Individuals with this type of cancer have an expected survival rate of approximately 8.5 months.

Sarcomatoid mesothelioma offers slightly reduced expectations, with a mean survival time of 7 months. Biphasic mesothelioma is the most dangerous, with diagnosed patients expects to survive 6 months.

Regardless of the type of mesothelioma, treatment typically involves a combination of methods. Usually, patients will undergo surgery to remove as much of the cancerous tissue as possible. If the cancer has not spread beyond the lungs or chest cavity, then recovery from mesothelioma may be possible. However, once the cancer has spread to other areas of the body (such as the lymph nodes), success rate for surgery alone drops dramatically.

In most cases, surgery is followed by chemotherapy and/or radiation therapy. These treatments attempt to halt or prolong the spread of cancer throughout the body. In some cases, such therapies can cause the cancer to go into remission.

As hinted at by the survival times listed above, different types of mesothelioma are more responsive to chemotherapy and radiation than others. In cases where such treatments prove ineffective, clinical trials may serve as a potential option for patients. These unproven experimental treatments often feature new drugs that may lead to effective treatments.

Unfortunately, all types of mesothelioma are exceptionally difficult to treat. In many cases, doctors must resort to palliative care. This involves taking steps to treat symptoms and relieving pain rather than attempting to find a cure for the cancer.

More information about mesothelioma pathology

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