Sarcomatoid Mesothelioma

Mesothelioma occurs in the mesothelium, a membrane that lines three of the body's cavities as well as male and female reproductive organs. The mesothelium is comprised of mesothelial cells.

Mesothelial cells, the structures responsible for malignant mesothelioma, are broken down into four major categories: epithelial, sarcomatoid, biphasic, and desoplastic. Biphasic mesothelioma is a "mixed" category, and desoplastic is a variant of sarcomatoid mesothelioma. Of these four types, the most common by far is epithelial mesothelioma, which accounts for approximately 50 to 70 percent of all known cases of the disease. The least common form of the three cellular types of malignant mesothelioma is sarcomatoid mesothelioma, which accounts for approximately 10 to 15 percent of known cases.

Sarcomatoid mesothelioma can be distinguished from other types based on the shape of the affected cells. A look through a microscope at sarcomatoid mesothelioma cells shows elongated, spindle-shaped cells. The cells are irregularly shaped (unlike the organized, self-similar epithelioid cell), and they tend to overlap one another somewhat haphazardly. Additionally, sarcomatoid mesothelioma cells do not have a clearly visible nucleus - while epithelioid cells have nuclei that can easily be seen under a microscope.

The major subset of sarcomatoid mesothelioma is desoplastic mesothelioma. It is considered to be a full-scale variant of sarcomatoid mesothelioma. It distinguishes itself by masquerading as healthy tissue - thus making the disease very difficult to diagnose.

Diagnosing Sarcomatoid Mesothelioma

For most mesothelioma patients, the road to diagnosis starts with a cataloguing of symptoms, followed by an imaging test such as an x-ray, MRI, CT scan, or PET scan. Once visible abnormalities are determined, the next step is generally to biopsy the affected tissue. During a biopsy, doctors gather samples of suspicious cells from the tumor and surrounding areas. The samples are then taken to a lab, where a technician will evaluate the cells to determine whether or not they are malignant and what type of cells they are.

One common form of gathering cells, the needle core biopsy, is not recommended for the diagnosis of sarcomatoid mesothelioma because the results can give false information that the cells being tested are harmless even when this is not the case. The cells gathered tend to look very "bland" and bear a striking resemblance to benign fibrous tissue.

Once the cells have been gathered, the first step of a biopsy generally includes a microscope scan to determine the general appearance of the cells. Cancerous cells can usually be distinguished from healthy cells because they look different and may have a different overall shape.

The second step is a test for the presence of molecules produced by cancer cells when they become malignant (such as oncoproteins). The person responsible for this analysis is generally a histologist. The chemical test is the definitive part of the biopsy process that will overrule any conjectures or assumptions made at earlier stages.

Histological methods of diagnosis can be difficult to use effectively in cases of sarcomatoid mesothelioma, in large part because the appearance of the affected cells can look like many other things. Pulmonary sarcomatoid carcinoma, for example, an unrelated form of cancer, looks quite a bit like sarcomatoid mesothelioma.

Treatment Options for Sarcomatoid Mesothelioma

Three treatment options are generally used in the treatment of mesothelioma: surgery, radiation therapy, and chemotherapy. In most cases, the treatment option recommended by your doctor will depend on the location and stage of a patient's cancer and not on the specific type of cells in the tumors.

Overall, sarcomatoid mesothelioma cells are incredibly hardy and resistant to treatment. The more common epithelioid cells generally respond more favorably to common treatments, and the prognosis for a newly diagnosed sarcomatoid mesothelioma patient is approximately seven months on average. However patients may choose to undergo treatment which can help combat the disease and yield positive results.

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