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Mesothelioma Cell Types

Pleural mesothelioma occurs as one of three types of cancer cells: Epithelioid, sarcomatoid or biphasic, which is a combination of both. Determining the mesothelioma cell type helps the doctor design the most effective treatment plan for each patient.

What Are the Types of Pleural Mesothelioma Cells?

Pleural mesothelioma cells arise from epithelial tissue. When epithelial cells become cancerous, they can develop into epithelioid or sarcomatoid cells, or a combination of the two, known as biphasic mesothelioma.

The main cell types of pleural mesothelioma are:

Epithelioid Cells
Epithelioid Cells
Sarcomatoid Cells
Sarcomatoid Cells
Biphasic Mesothelioma Cells
Biphasic Cells

Histology of Pleural Mesothelioma Cells

Histology is the microscopic study and examination of tissue appearance, organization and function.

In addition to determining pleural mesothelioma cell type, American Society of Clinical Oncology 2018 pleural mesothelioma treatment guidelines recommend cancer biopsy samples be examined with a type of histology test called immunohistochemistry.

Your doctors can learn more about your cancer and ensure the diagnosis is accurate with immunohistochemistry tests. This will identify the presence and absence of cell markers to confirm the mesothelioma diagnosis and rule out other diseases.

These additional histology lab tests are important for confirming the pathologist’s original determination of the cell type of each patient’s mesothelioma.

An accurate mesothelioma diagnosis is important because it helps your doctor determine the best treatment option and provide an assessment of your life expectancy.

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Why Is Mesothelioma Cell Type So Important?

Determining each patient’s pleural mesothelioma cell type is important for minimizing the risk of mesothelioma misdiagnosis.

For example, misdiagnosis of sarcomatoid cells can happen because these cells closely resemble other conditions, such as localized fibrous tumors, metastasized renal cell carcinoma, fibrosarcoma, fibrous pleurisy, malignant fibrous histiocytoma, adenocarcinoma and pleural liposarcoma.

Also, the type of mesothelioma treatment your cancer doctor plans for you may vary based on mesothelioma cell type.

Treatment Based on Cell Type

Another reason identifying the cell type is important is because each cellular pattern can affect the recommended treatment plan. Cells respond differently to treatment. This is why histology, or the study of cell anatomy, plays a vital role in developing the most effective treatment plan for patients.

Reaction to Treatment by Cell Type

The type of cell present in each case can account for up to a 200-day difference in life expectancy.

A team of mesothelioma specialists will determine the prognosis and the best course of treatment based on what cell type is present, location, stage of the cancer and overall health of the patient. A more aggressive treatment plan may be available for epithelioid cases.

If you have a history of asbestos exposure and receive a diagnosis for a cancer or condition other than pleural mesothelioma, you should seek a second opinion. This can ensure the diagnosis is correct and help you receive effective treatment as quickly as possible.


Snehal Smart, M.D.

Snehal Smart, M.D.

Snehal Smart is the Pleural Mesothelioma Center’s in-house medical doctor, serving as both an experienced Patient Advocate and an expert medical writer for the website. When she is not providing one-on-one assistance to patients, Dr. Snehal stays current on the latest medical research, reading peer-reviewed studies and interviewing oncologists to learn about advancements in diagnostic tools and cancer treatments.

Medically Reviewed By Dr. Joanne Getsy
Last Modified March 18, 2019

6 Cited Article Sources

  1. Oregon State. (n.d.). Open Oregon State. Anatomy & Physiology. 4.1 Types of Tissues. Retrieved from http://library.open.oregonstate.edu/aandp/chapter/4-1-types-of-tissues/
  2. Harris, E.J.A. et al. (2019, January 16). Diagnosis of asbestos-related lung diseases. Retrieved from https://www.tandfonline.com/doi/full/10.1080/17476348.2019.1568875
  3. Ettinger, D.S. et al (2016, July). NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016. Retrieved https://jnccn.org/abstract/journals/jnccn/14/7/article-p825.xml
  4. Kindler, H. et al. (2018, May 1). Treatment of Malignant Pleural Mesothelioma: American Society of Clinical Oncology Clinical Practice Guideline. Retrieved from http://ascopubs.org/doi/pdf/10.1200/JCO.2017.76.6394
  5. Rossini, M. et al. (2018, April 3). New Perspectives on Diagnosis and Therapy of Malignant Pleural Mesothelioma. Retrieved from https://www.frontiersin.org/articles/10.3389/fonc.2018.00091/full
  6. Ledda, C. et al. (2018, June 15). Biomarkers for Early Diagnosis and Prognosis of Malignant Pleural Mesothelioma: The Quest Goes on. Retrieved from https://www.mdpi.com/2072-6694/10/6/203

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