Epithelial Mesothelioma

The term malignant epithelial mesothelioma describes a specific cell type that may be involved in your case. If epithelial mesothelioma (also called "epithelioid") cells are present, you may have a better prognosis and be more responsive to treatment in comparison to patients with other cell types. Understanding the characteristics of epithelioid mesothelioma, how it is diagnosed, and what treatments are available will help you understand how cell types affect your prognosis.
Because malignant epithelial mesothelioma accounts for 50 to 70 percent of all cases, more research has been performed on this cell type. Although treatment does not typically differ from one cell type to the next, knowing which type is present may dictate which clinical trials are available to you. Some doctors consider cell type during their research in an effort to further understand the response rates patients have towards certain treatments.

Characteristics of Epithelioid Mesothelioma

Mesothelioma cell types are classified by the appearance of the cells that form the cancer. Epithelial cells are part of the epithelium, or layers of cells that cover the internal surfaces of the body. The cells look like small, tube-like structures. When the epithelial cells turn cancerous, they are called epithelioid cells. Epithelioid mesothelioma most commonly occurs in malignant pleural mesothelioma.

How Epithelioid Mesothelioma is Diagnosed

Epithelioid mesothelioma is not easily identified through the microscopic inspection of cells. To determine which type in present, a thoracoscopy or another type of surgical biopsy needs to be performed. Biopsies offer doctors a way to examine the cells and tissue associated with the tumor. During a biopsy, a sample of the tumor is extracted for further evaluation.
Epithelioid mesothelioma may be confused with adenocarcinoma, or a type of cancer that develops in the cells in internal organs such as the lungs, breasts and colon. Glandular mesothelioma, an epithelial cell subtype, may resemble adenocarcinoma of the lungs. It may be difficult to diagnose these two conditions, as simple biopsies of the pleura are often ineffective and surgical biopsy may be necessary.
The specific cell type that is involved in your case will be revealed in the pathology report. If you haven't been told your cell type yet, just ask your doctor and consider requesting a copy of the pathology report for your records.

Epithelioid Mesothelioma Subtypes

When epithelial cells turn cancerous (mesothelioma), they can be classified as epithelioid or sarcomatoid (or "biphasic" if both epithelioid and sarcomatoid cells are present). Both types are determined by their physical characteristics: the size, shape and structure of the cell. Epithelial cells may even be further classified as one of the following subtypes:
Deciduoid mesothelioma is an uncommon subtype of epithelial mesothelioma. It accounts for less than 5 percent of all mesotheliomas in general.

How Epithelial Cells Affect Treatment and Prognosis

Treatment for epithelial mesothelioma is similar to treatments for other cell types. In fact, mesothelioma treatment more often depends on the stage and location of the cancer rather than the specific cell type. However, since epithelioid cells respond best to treatment, an epithelioid mesothelioma patient may be considered for a more aggressive treatment plan that patients with other cell types. Some of the most common treatments include:
The presence of epithelial cells usually results in a better prognosis in comparison to sarcomatoid and biphasic subtypes. The median survival time of patients with epithelial mesothelioma is about one year following diagnosis. The improved prognosis isn’t much, usually a matter of months in most cases, but could amount to more than several months or years if diagnosed in an early stage.

Want More Information About Epithelioid Mesothelioma?

Learning about your specific cell type is one of the more technical aspects of your diagnosis. If you still have questions, feel free to contact one of our Patient Advocates at (800) 615-2270. Additional information can also be received by filling out the form on this page.
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