Sarcomatoid Mesothelioma - What Is Sarcomatoid Mesothelioma?

Sarcomatoid Mesothelioma
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Sarcomatoid mesothelioma is a rare cell type caused by asbestos exposure. It accounts for approximately 10 – 20% of all mesothelioma diagnoses. Sometimes referred to as spindle cell mesothelioma, sarcomatoid cells are recognized by their oval, spindle shape. This cell type typically forms in separate nodes or lesions and can metastasize, or spread, quickly to distant organs. It is also the most difficult cell type to treat, with an average prognosis of six months.

What Is Sarcomatoid Mesothelioma?

Sarcomatoid mesothelioma is a less common cell type. It accounts for about 10 – 15% of all pleural mesothelioma diagnoses and 4% of peritoneal mesothelioma diagnoses.

There are several defining characteristics that can help identify sarcomatoid cells:

1) An oval, elongated shape with a large nucleus.
2) Multiple nuclei in some cells.
3) Unstructured formation in fibrous nodes or lesions.
4) Distant cell formation that is faster to metastasize than other cell types.

Because sarcomatoid cells are notable for their oblong, spindle shape, sarcomatoid mesothelioma is also referred to as spindle cell or sarcomatous mesothelioma.

Compared to other mesothelioma cell types, malignant sarcomatoid cells are more aggressive. This type of mesothelioma cancer is also considered more difficult to diagnose and treat. Sarcomatoid cells mimic healthy cells and are also frequently misdiagnosed.

Symptoms. - Sarcomatoid Mesothelioma Symptoms.

Malignant sarcomatoid mesothelioma symptoms may take 10 – 50 years to develop. Patients may experience different symptoms depending on where the cancer develops.

Sarcomatoid cells are most common in malignant pleural mesothelioma, which impacts the lining of the lungs. In rare cases, patients may be diagnosed with sarcomatoid peritoneal mesothelioma. This type of mesothelioma develops in the abdominal lining.

Common Symptoms of Sarcomatoid Mesothelioma.

Abdominal or chest pain.
Decreased appetite.
Difficulty breathing (dyspnea).
Excess fluid in the lungs or abdomen.
Fatigue.
Nausea and vomiting.
Persistent cough.
Shortness of breath.
Weight loss.

Because malignant sarcomatoid cells spread quickly, sarcomatoid patients may experience worsening symptoms earlier than patients with epithelioid or biphasic cell types.

Diagnosis - Diagnosing Sarcomatoid Mesothelioma.

Properly identifying mesothelioma cell type is an important aspect of the diagnostic process. Sarcomatoid malignant mesothelioma is difficult to accurately diagnose because of its rarity and resemblance to other conditions.

Diagnosis typically begins with imaging tests, including an X-ray and CT scan. These tests will identify any visible tumors or excess fluid in the chest cavity. If cancer is suspected, doctors may order a blood test. This test identifies biomarkers that can differentiate mesothelioma from other conditions.

A biopsy is the most important step in making an accurate sarcomatoid mesothelioma diagnosis. Cell type can be determined through a tissue biopsy and analyses of the sample, such as immunohistochemistry. This is a staining method that uses specific antibodies to isolate antigens or proteins in the tissue sample.

Through an immunohistochemical stain, a pathologist can identify if a tumor is benign or malignant, as well as determine cell type, stage and prognosis.

Several immunohistochemical markers can indicate mesothelioma. Studies have found stains that test positive for proteins calretinin and D2-40, in combination with the antibody pancytokeratin, are the most accurate indicator of sarcomatoid mesothelioma.

Multiple biopsies may be necessary to determine if a patients’ tumors solely exhibit sarcomatoid cells. In some cases, epithelioid cells may also be present, indicating biphasic mesothelioma. Additional tests may also be needed to make an accurate differential diagnosis.

Common misdiagnoses of sarcomatoid mesothelioma include:

Fibrous pleurisy.
Fibrous tumors.
Fibrosarcoma.
Metastasized renal sarcoma.
Non-Hodgkin’s lymphoma.
Pleural liposarcoma.
Sarcomatoid carcinoma.
Soft tissue sarcomas.

Sarcomatoid Mesothelioma - What Is Sarcomatoid Mesothelioma?
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