Biphasic Mesothelioma

Biphasic mesothelioma is the second most common cellular form of this disease, accounting for 20 to 40 percent of all known cases. As the name implies, biphasic mesothelioma is a mixture of two types of cancer cells.

Characteristics

Unlike the more common epithelioid type, biphasic mesothelioma cells lack a specific structure. This type of mesothelioma is a mix of epithelioid and sarcomatoid cells. Whereas the former has a clearly visible nucleus and is found in uniform, organized arrangements and tend to be of a single shape, sarcomatoid cells are more oval or oblong shaped and have no easily identifiable nucleus. Although both types are present in a biphasic tumor, they have a tendency to form in differentiated groups; they are not usually found in the same area of the tumor.

Diagnosis and Treatment

Mesothelioma is exceptionally difficult to diagnose, which is why it is usually not discovered until it has reached an advanced stage. It is important to confirm a history of asbestos exposure, as mesothelioma symptoms are similar to a wide range of respiratory illnesses.

The primary physician usually takes an x-ray; if there is cause for concern, the patient is referred to a radiology lab, where more advanced images are taken. If abnormal areas are discovered, a tissue sample, or biopsy is taken to confirm the diagnosis.

A recent test developed by a Japanese biotech company, called MESOMARK, may help pathologists in diagnosing mesothelioma at an earlier stage, when it is most treatable.

Treatment in most cases is limited to palliative ones, since the disease is usually diagnosed too late for surgery. Mesothelioma is usually treated with some combination of radiation and chemotherapy; surgical techniques may be used to relieve the symptoms, but in the later stages are usually not effective in treating the disease.


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Sarcomatoid Mesothelioma

Mesothelioma is a cancer that attacks the lubricative layer lining the inside of the chest and abdomen and the internal organs. Pathologists categorize cases according to levels of criteria, which are as follows:

Location:

• Lungs (pleural)
• Abdomen (peritoneal)
• Heart (pericardial)

Stage:

• Stage I - Cancer cells have started to form
• Stage II - Cancer has spread locally
• Stage III - Cancer has spread to adjoining areas
• Stage IV - Cancer has begun to metastasize
  
  

Cellular Structure:

• Epithelial (organized and structured)
• Sarcomatoid (random and irregular)
• Biphasic (a mix of epithelial and sarcomatoid)
• Desoplastic (a variation of the sarcomatoid variety)

Cellular structure is determined by an actual visual examination of the cells under a microscope.

About Sarcomatoid Mesothelioma

Sarcomatoid Mesothelioma accounts for approximately 10 to 15 percent of all diagnoses. The cancer cells in this case are elongated and spindle-shaped, and are arranged in a rather haphazard way. Sarcomatoid cells also lack a nucleus, unlike epithelioid cells, which have clearly visible nuclei.

The desoplastic variety of sarcomatoid mesothelioma is difficult to distinguish from healthy tissue in many cases, making an accurate diagnosis challenging.

Diagnosis

Once symptoms have been cataloged and a history of asbestos exposure determined, the next step is to look inside the body - initially with x-rays, followed up by more sophisticated imaging such as CT scans or MRIs. If these images reveal serious abnormalities, a biopsy (tissue samples) will be ordered. These are examined and analyzed at a lab, which usually confirms or contradicts the diagnosis.

When it comes to the sarcomatoid mesothelioma, traditional methods of biopsy pose additional challenges; the normal "needle core" method often results in false information, as sarcomatoid cells are often similar in appearance to benign fibrous tissue. Additionally, histological methods of diagnosis often make it difficult to distinguish between sarcomatoid mesothelioma and other types of unrelated sarcomatoid cancers.

A precise and accurate diagnosis is vital, because a misdiagnosis can lead to an inappropriate course of treatment being prescribed; it is a good idea to get a second and even a third opinion if mesothelioma is suspected.

Treatment Options

Although the details will differ depending on the individual case, all forms of cancer are treated through some combination of surgery, radiation therapy, and chemotherapy. How these are administered depends on the location and stage of the cancer.

Unfortunately, sarcomatoid mesothelioma is notoriously resistant to treatment, and prognosis is not good. Average survival rates between diagnosis and death is seven months.


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Epithelial Mesothelioma

Epithelial mesothelioma cells have a definite structure with visible nuclei. This is the most common variant of this type of cancer, accounting for about 60 percent of all cases. This type of mesothelioma develops when malignant cells develop on any of the mesothelial linings. When examined under a microscope, these cells are of a uniform size and shape, and resemble normal, healthy epithelial cells.

Epithelial mesothelioma cells also bear a strong resemblance to adenocarcinoma cells, which are also associated with lung tissue. Patients who have been diagnosed with adenocarcinoma should also be examined for mesothelioma as well.

Variants

Papillary mesothelioma is an example of epithelial mesothelioma; other variants include any of the following:

• Signet Ring
• Single File
• Adenoid Cystic
• Glandular
• Tubulopapillary
• Histiocytoid
• Microcystic
• Macrocystic
• Glomeruloid
• Diffuse - NOS
• Small Cell
• Deciduoid
• Pleomorphic
• In Situ
• Mucin Positive
• Well-Differentiated Papillary
• Gaucher Cell-Like

What differentiates these various types are the shape, size and formation of the cells. This can determine what course of treatment is appropriate for the patient's situations.

Epithelial Mesothelioma and Asbestos

Once asbestos fibers are inhaled, they become lodged in the lung tissue, where they remain indefinitely. Mesothelioma is associated with hard, crystalline amphibole asbestos, which consists of hard, needle-like fibers that literally bore through lung tissue over time, causing chronic inflammation that ultimately results in malignancy. The disease has a very long latency period, which can be anywhere from five to seventy-five years. The symptoms of the disease are also similar to other respiratory illnesses, which is why mesothelioma has historically been so difficult to diagnose.


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Mesothelioma Cell Types

Malignant mesothelioma can also be classified by different cancer cell types, each of which tends to behave differently. There are three classifications assigned to mesothelioma cell types.

Epithelial Mesothelioma is the most common cell type and accounts for approximately 50-75% percent of all diagnosed cases each year. These cells are uniform in shape, with an elongated pattern that makes them easily distinguishable when viewed under high magnification. These cancers are adenocarcinomas, malignancies which are more commonly associated with pure lung cancers as opposed to cancers of the mesothelium.

Learn more about:

• Epithelial Mesothelioma
• Sarcomatoid Mesothelioma
• Biphasic Mesothelioma

Sarcomatoid mesothelioma is a less common cell type, accounting for between 7 and 20% of diagnosed cases each year. These cells grow forth out of supportive structures, such as muscles and bones.

Biphasic mesotheliomas are those with a mix of epithelial and sarcomatoid cell types. Treatment options do not vary greatly between cell types, but often sarcomatoid mesotheliomas are more difficult to treat as a result of the surrounding affected tissues from which they spread.

Thoracoscopy and the use of special stains can be helpful in identifying cellular classifications, though obtaining adequate tissue samples often require more invasive surgeries.

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Risk of Asbestos

The research we do for our client's cases results in a large amount of pertinent and up to date information on asbestos, the asbestos industry, asbestos cancers and treatment options. We have compiled that information here in an on-line information library. We hope that by providing this information, we create a valuable resource, which will benefit people who have access to it. This section will be updated regularly as we uncover new and important information.



There are a number of alternatives to using asbestos products when constructing a new home or commercial building, and many of these are considered to be "green" options, as they are good for the environment and are also easy on a budget. It is important to educate yourself as to how each alternative works before choosing which product to use. Our section on asbestos alternatives provides information about several popular and cost-effective options, all of which are safe, affordable, and environmentally friendly.
Jobsites

If you or a relative has ever worked at one of the Jobsites listed, you may have been exposed to high levels of asbestos and could be at risk to develop asbestos cancer including malignant mesothelioma.
Who is at Risk?

Virtually anyone who breathed asbestos dust. Exposures usually occur at major construction Jobsites, in shipyards, onboard navy vessels and during construction or renovation of commercial buildings. People in the vicinity of boilers and piping often are at risk. In addition, teachers, students, and other staff members who work in older school buildings may be at risk of exposure to asbestos products, such as ceiling or floor tiles. Equally at risk are families of these workers, as asbestos often was carried home on clothing.
Asbestos Legislation

Information about the asbestos legislation currently being proposed in the Senate.
Asbestos Removal

There are over 3,000 manufactured products that are known to contain asbestos. The only way to truly remove the threat of asbestos exposure and its dangerous health effects is to remove all asbestos from the premises.
Asbestos Contractors

A nationwide asbestos services directory to provide assistance with locating companies and contractors specializing in asbestos testing, asbestos removal and asbestos consulting.
Companies

Clients of Early, Ludwick and Sweeney have successfully received settlements and awards from a host of asbestos manufacturers and distributors. Listed here is a sampling of these companies. Your employer may be listed here.
Products

You may not realize all of the types and forms of materials that contained asbestos. Many of the products which may be familiar to you appear here and are part of our extensive database.
Unions

We have compiled a comprehensive resource for union workers who developed mesothelioma as a result of on-the-job asbestos exposure. In recent years trade unions have rallied for the rights of workers who were unknowingly exposed to this dangerous material.
Asbestos Related Diseases

Since we represent families throughout the country, we have become familiar with medical doctors who specialize in aggressively treating malignant mesothelioma, lung cancer, asbestosis, and pleural mesothelioma.

We keep up to date on the newest research, diagnosis information and treatment options for these asbestos exposure related diseases.


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