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Cell Types of Mesothelioma

When it comes to mesothelioma, treatment and prognosis may be directly impacted by the mesothelioma cell type.

There are one of three cellular patterns that comprise mesothelioma:

  • Epithelioid
  • Sarcomatoid
  • Biphasic

Determining the mesothelioma cell type is important because certain treatments may respond better to some treatments than others.

At The Law Offices of Jeffrey S. Glassman, our mesothelioma lawyers in Boston recognize the enormity of decisions facing victims of asbestos-related diseases and their families. Getting a proper early diagnosis is key to achieving optimal outcomes.

Although our focus is on the legal implications of mesothelioma – such as how you were exposed to asbestos and to what extent those entities may be liable – this requires that we be well-versed in the pathology of the disease.

Doctors use a special type of test called histology to both distinguish mesothelioma from other types of cancers and to determine the cell type. For example, mesothelioma can be tough to tell apart from adenocarcinoma, which is a type of lung cancer that is seen most frequently among non-smokers.

The Three Mesothelioma Cell Types

The three types of mesothelioma cells are:

  • Epithelioid. This is the most common cellular form of mesothelioma, accounting for between half and 70 percent of all mesothelioma diagnoses. It tends to be easier to treat because of the square shape of the cells. These cells tend to stick together during replication, which slows the spread and makes curative treatments, such as surgery, radiation or chemotherapy, that much more effective in removing the cancer from the patient’s body. Subtypes include: Tubulopapillary, Acinar, Adenomatoid and Solid Mesothelial.
  • Sarcomatoid. This cellular form of mesothelioma is the least common, accounting for just 10 percent of all mesothelioma diagnoses. Unfortunately, it is also the most aggressive. It spreads quickly, due to its thin shape and patchwork pattern of rapid growth. Once this tumor spreads, surgery is not usually an option. Subtypes of sarcomatoid cells include: Desmoplastic, Lymphositocytoid and Transitional.
  • Biphasic. This is a mixed cell type, accounting for between 20 to 35 percent of all mesothelioma diagnoses. It is comprised of both sarcomatoid and epithelioid cells. This can be tough to diagnose because the sarcomatoid and epithelioid cells may grow in separate parts of the same tumor.

It is important to determine which cell types of mesothelioma are involved in your illness to optimize your opportunity for success.

Mesothelioma Histology

Per research outlined in the journal Archives of Pathology & Laboratory Medicine, malignant mesothelioma is an uncommon type of tumor that can be difficult to diagnose. That’s why there are established practical guidelines that can be followed.

The group first notes that a diagnosis of malignant mesothelioma must always be based on results obtained from a biopsy. Interestingly, a history of asbestos exposure is not necessarily taken into consideration by a pathologist when diagnosing malignant mesothelioma. That’s because the pathologist – as noted by Johns Hopkins Medicine – makes his or her diagnosis or determination based solely on test results. This includes determinations of cell types. (Pathology involves study of the nature, cause and effect of diseases.)

Histology is the primary way to identify and sort cancer cells. Histology is a branch of medicine and biology that involves the study of cells and tissues. Those cells are then stained on a slide and observed under a microscope, where the composition and structure of each cell can be more closely analyzed.

Specifically with mesothelial cells, we’re talking about histopathology, or the study and testing of diseased cells. Malignant cells that multiply rather than die off result in a tumor, and each tumor is comprised of different cell types.

Histology is necessary in differentiating between mesothelioma and other types of cancer. For example, we know that peritoneal cancer and ovarian cancer can be difficult to discern in female patients absent identification of cell type via histopathology.

The process of histology generally goes like this:

  • Biopsy. Tissue samples are obtained and prepared for study through a biopsy. This can be done through in-patient or out-patient procedure. Once these samples are collected, they are prepared by histotechnicians.
  • Preparation. Histotechnicians are responsible to preserve and stain the cells so they can be properly observed. First they have to fix the cells in a chemical that makes them more rigid. Then they need to embed those samples into blocks of resin. Then they must second them into thin samples. From there, the resin blocks will be sliced.
  • Analysis. From there, histopathologists will view the slide under a microscope to determine the type of cancer, as well as the cell types of mesothelioma with which they may be viewing.

These findings will be used, along with the location and stage of the disease, to determine the appropriate treatment for a mesothelioma patient.

Diagnosing Mesothelioma

In general, there is no clear and narrow path to diagnosis of mesothelioma. It is often an exhausting process that involves blood tests, imaging tests and numerous biopsies.

Identification of mesothelioma types through histopathology is only one step in that process, and it should be noted that differences in particular cell types may be very subtle, which can sometimes make diagnosis a significant challenge.

This is further complicated by the fact that early symptoms of mesothelioma tend to be confused with other more common – and less serious – illnesses.

Most mesothelioma patients will have a team of physicians, including an oncologist and a pathologist, who understand the various subtleties involved. Although histopathologists do not consider a history of asbestos exposure in making their determination, it is important to inform your doctor if you have this history.

It’s also important if you are diagnosed with mesothelioma to contact an experienced attorney who can help you determine what your legal options may be. In many cases, there is an avenue for financial compensation, because a great deal of asbestos exposure in the 20th century was the result of companies that concealed the dangers of their product or services.

Mesothelioma Prognosis

The long-term prognosis for patients with mesothelioma is poor. That said, those who are diagnosed with the most common mesothelioma cell type, epithelial, will have the best odds for longer survival. In some instances, individuals have lived five to 10 years beyond diagnosis with early diagnosis, aggressive treatment and proper management.

Because time is of the essence for every mesothelioma patient, it’s important to explore your legal options as soon as possible.

Contact the Law Offices of Jeffrey S. Glassman today for a free and confidential consultation.

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