Distinguishing Between Different Types Of Malignant Mesothelioma

by Asbestos Victim Advice

Diagnosis of asbestos-related disease, mesothelioma, is not so straightforward. Not only can first symptoms be confused with other types of medical conditions such as influenza or bronchitis, and seemingly similar types of cancers, but even the disease itself can be divided into categories, each requiring different or a combination of treatments.

Throughout the UK's peak period of asbestos use in manufacturing, engineering and construction, until the late 1970s and early 80s, the lack of asbestos awareness to the deadly dangers of breathing in the toxic asbestos fibre dust by company employees would often lead to a misunderstanding when mesothelioma or asbestosis symptoms emerged.

The long development of asbestos-related disease of up to 40 or 50 years would mean often attributing a prolonged cough, shortness of breath or weight loss, for example, to a history of cigarette smoking or catching a bout of flu or bronchitis. Unfortunately, there would also be instances where a doctor's diagnosis would also fail to recognise the onset of asbestosis based disease, which would have been vital in catching the aggressive cancer before the tumours could spread and improve the chances of effective asbestosis treatments, such as radiotherapy and biopsy.

The prognosis for malignant mesothelioma at Stage 3 or Stage 4 is little more than 12 - 18 months, possibly 2 years. Good nutrition and general palliative care can help make a better quality of life in the remaining time.

Malignant mesothelioma, which occurs in the mesothelium, a protective layer of tissue called an epithelium surrounding organs such as the lungs, is divided into three cell types or histological ( microscopic tissue) categories:
Epithelioid mesothelioma.
Sarcomatoid mesothelioma.
Biphasic mesothelioma.

Malignant mesothelioma types are also divided into further sub-types under each category as in many cases, malignant mesothelioma patients will possess more than one cell type.

Malignant Epithelioid mesothelioma accounts for around 50 - 70 per cent of all malignant mesothelioma cases and is the most common cell type. Epithelioid cells are an uniform cube shape and tubular pattern containing an unique cell nucleus and can be often confused with adenocarcinoma, a malignant tumour found in glandular tissue.

Malignant Sarcomatoid Mesothelioma is often confused with other types of cancer because of the irregular oval shape of the cell, but mostly mistaken for sarcomatoid carcinoma, which is rare in the lungs. Also erroneously attributed to sarcoma, pulmonary sarcomatoid carcinoma, and high-grade sarcoma, a form of cancer found in the body's supportive tissue including bone, cartilage, fat or muscle. The nucleus of a sarcomatoid cell is more difficult to detect under an electron microscope than the nuclei of epithelioid mesothelioma cells.

This form of malignant mesothelioma is still currently the most deadliest, accounting for around 10-15 or sometimes 20 per cent of all mesothelioma cancer cells, which is the least common malignant mesothelioma diagnosis. Death usually occurs within six months of diagnosis.

Malignant Biphasic Mesothelioma or "mixed biphasic mesothelioma" is rapidly establishing itself as a major type of malignant mesothelioma, and currently seen in more than half of all malignant mesothelioma cases. A combination of epithelioid and sarcomatoid mesothelioma cancer subtypes, biphasic mesothelioma does not have a distinct cellular structure, but rather two very different mesothelioma cell types. The tumour contains the two different subtypes in different parts of the structure, so diagnosis of biphasic mesothelioma, means a diagnosis of both epithelioid and sarcomatoid mesothelioma cancer.

Treatments for all three malignant mesothelioma types are similar, which may be used alone or in combination with one another.

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