Epithelial (or epithelioid) mesothelioma is the most common histological type of mesothelioma. Epithelial mesothelioma is a subtype – both pleural and peritoneal mesothelioma may be epithelial or sarcamatoid or biphasic (including both cell types.)
Epithelial mesothelioma has a better prognosis than other subtypes. Average life expectancy after diagnosis is longer.
As with all types of mesothelioma, asbestos is the cause. Most people who get it are men past age 50, although it does occur in younger people and in women. This is largely because the illness typically does not manifest until decades after initial asbestos exposure. significant percentage of patients diagnosed at relatively younger age have experienced asbestos exposure during their childhood. Approximately 70 to 80 percent of mesothelioma cases involve a male patient. This is due to the fact that men are more likely to be employed at jobs that have a heightened risk for asbestos exposure. Common industries linked to asbestos inhalation include construction, auto repair, shipbuilding and naval employment.
Epithelial Mesothelioma Symptoms
The symptoms of epithelial mesothelioma are the same as those of other subtypes.
Pleural mesothelioma symptoms chest pain and dyspnoea. Dyspnoea is the clinical term for shortness of breath. Dysphagia (difficulty swallowing) is another common symptom linked to mesothelioma. Less common symptoms of the illness include weight loss, sweating and a chest wall mass.
Peritoneal mesothelioma symptoms include ascites (fluid in the abdomen), abdominal pain, and digestive disorders. For peritoneal-specific cases of mesothelioma, loss of appetite, vomiting, nausea, and bowel issues may also be indicators of the disease.
One thing that sets mesothelioma apart from other cancers is a history of exposure to asbestos. Even brief or seemingly incidental exposure may be enough to cause mesothelioma.
Doctors may order X-rays, CT scans, MRI scans and fluid biopsies in an attempt to narrow down the range of diseases you might have. If you have mesothelioma, these tests can help the physician rule out other illnesses. The only way to definitively establish a diagnosis of mesothelioma is through a biopsy. The doctor takes a tissue sample from the body and examines it under a microscope.
Diagnosing Epithelial Mesothelioma
Epithelial mesothelioma can be difficult to diagnose. This is partly due to the fact that expressed symptoms of the disease are common among many other illnesses. However, a physical examination may result in the identification of pleural effusion or pleural thickening as a result of the tumor. Blood tests can also serve as early indicators to the disease.
Once mesothelioma is suspected, a CT scan, MRI and/or PET scan may be ordered in the attempt to identify a mesothelioma tumor. However, to properly diagnose mesothelioma, a biopsy is required. This involves extracting a small tissue sample from the affected area and viewing it under a microscope.
In many cases, malignant epithelioid mesothelioma is misdiagnosed initially and patients may have to undergo multiple consultations and tests before a correct diagnosis can be achieved. A correct diagnosis is essential for selecting appropriate treatment..
While thoracentesisor closed pleural biopsy can usually help confirm the diagnosis of pleural malignancy, enough tissue may not be obtained to make a differentiation between mesothelioma and lung adenocarcinoma. Moreover, negative results do not imply the absence of mesothelioma. Surgical procedures (via open thoracotomy or video thoracoscopic biopsy) have shown to provide a more sure diagnosis.
Around 10% of patients who go through diagnostic procedures for mesothelioma end up seeding the biopsy site with tumor cells which later leads to recurrance in the chest wall. Radiation therapy is often used for the treatment of patients diagnosed with symptomatic, recurrent disease occurring at the site of biopsy. Such complications can be avoided if prophylactic radiation therapy is administered to the surgical scar or thoracentesis site.
A new approach to differentiate between epithelial mesothelioma and adenocarcinoma of the lung is currently under development. This new approach relies on gene expression profiling, by identifying specific genes that are expressed in malignant mesothelioma but not in case of adenocarcinoma or normal lung tissue.
Complications of an Epithelial Mesothelioma Diagnosis
Finding and identifying cancerous cells can be difficult during a biopsy. Diagnosis is further complicated by the fact that mesothelioma acts remarkably similar to other forms of cancer. Epithelioid mesothelioma cells are often confused for adenocarcinoma cells, and vice versa. Multiple biopsies may be necessary. Though no current diagnosis procedure provides 100 percent effectiveness, searching for several biological markers of the illness generally leads to a correct diagnosis.