Sarcomatoid Mesothelioma

Mesothelioma is a cancer that attacks the lubricative layer lining the inside of the chest and abdomen and the internal organs. Pathologists categorize mesothelioma cancer cases according to levels of criteria, which are as follows:
Location:

• Lungs (pleural mesothelioma)
• Abdomen (peritoneal mesothelioma)
• Heart (pericardial mesothelioma)

Stage:

• Stage 1 Mesothelioma - Cancer cells have started to form
• Stage 2 Mesothelioma - Cancer has spread locally
• Stage 3 Mesothelioma - Cancer has spread to adjoining areas
• Stage 4 Mesothelioma - Cancer has begun to metastasize

Cellular Structure:

• Epithelial (organized and structured)
• Sarcomatoid (random and irregular)
• Biphasic (a mix of epithelial and sarcomatoid)
• Desoplastic (a variation of the sarcomatoid variety)

Cellular structure is determined by an actual visual examination of the cells under a microscope.

About Sarcomatoid Mesothelioma

Sarcomatoid Mesothelioma accounts for approximately 10 to 15 percent of all diagnoses. The mesothelioma cell types in this case are elongated and spindle-shaped, and are arranged in a rather haphazard way. Sarcomatoid cells also lack a nucleus, unlike epithelioid cells, which have clearly visible nuclei.
The desoplastic variety of sarcomatoid mesothelioma is difficult to distinguish from healthy tissue in many cases, making an accurate mesothelioma diagnosis challenging.

Diagnosis

Once mesothelioma symptoms have been cataloged and a history of asbestos exposure determined, the next step is to look inside the body - initially with x-rays, followed up by more sophisticated imaging such as CT scans or MRIs. If these images reveal serious abnormalities, a biopsy (tissue samples) will be ordered. These are examined and analyzed at a lab, which usually confirms or contradicts the diagnosis.
When it comes to the sarcomatoid mesothelioma, traditional methods of biopsy pose additional challenges; the normal "needle core" method often results in false information, as sarcomatoid cells are often similar in appearance to benign fibrous tissue. Additionally, histological methods of diagnosis often make it difficult to distinguish between sarcomatoid mesothelioma and other types of unrelated sarcomatoid cancers.
A precise and accurate diagnosis is vital, because a misdiagnosis can lead to an inappropriate course of mesothelioma treatment being prescribed; it is a good idea to get a second and even a third opinion if mesothelioma is suspected.

Treatment Options

Although the details will differ depending on the individual case, all forms of cancer are treated through some combination of surgery, radiation therapy, and chemotherapy. How these are administered depends on the location and stage of the cancer.
Unfortunately, sarcomatoid mesothelioma is notoriously resistant to treatment, and the mesothelioma prognosis is not good. The average mesothelioma survival rate between diagnosis and death is seven months.

Source

Hammer, Samuel P. "Macroscopic, Histologic, Histochemical, Immunohistochemical, and Ultrastructural Features of Mesothelioma." Society of Ultrastructural Pathology Companion Meeting, 27 February 2005, http://sup.ultrakohl.com/Uscap/uscap05/meso1.pdf