What is Biphasic Mesothelioma?

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Malignant mesothelioma is classified into four types based on the malignancy’s point of origin in the body. Once the type has been distinguished, mesothelioma is then classified by the cancer’s cell type, which is determined after review under a microscope. There are four of these subtypes:

  • Epithelioid
  • Sarcomatoid
  • Biphasic
  • Desmoplastic

Biphasic mesotheliomas are both epithelioid and sarcomatoid and comprise approximately 30 to 40 percent of all mesotheliomas according to the American Cancer Society.

Mixed Mesothelioma Types

Biphasic mesothelioma is often referred to as “mixed” because it consists of two other cell types, epithelioid and sarcomatoid. These cell types can be either within close proximity to one another or in distinctly separate locations within the same tumor. Diagnosing biphasic mesothelioma can sometimes be difficult due to the need to identify these different cell types. Mesothelioma treatments, as well as clinical trial studies, are often type and location specific. While their symptoms are usually similar, a proper diagnosis of the point of origin and cell characteristics can have an effect on a patient’s prognosis. The more specific a diagnosis, the more effective treatments and drugs can be.

Characteristics of Biphasic Mesothelioma

When viewed under a microscope, the cells of biphasic mesothelioma will appear as follows:

Epithelioid mesothelioma–comprised of round, cube-like cells that have long, slender microvilli. Microvilli are small hair-like protrusions in the cell membrane.
Sarcomatoid mesothelioma–made up of spindle-shaped cells arranged in a haphazard manner.

A proper diagnosis of biphasic mesothelioma involves first distinguishing between mesothelioma and other types of cancer that have biphasic characteristics such as synovial sarcomas and carcinosarcomas. Utilizing scientific techniques such as immunohistochemistry, which identifies and labels specific proteins in cells, can be used to distinguish biphasic mesothelioma from these other diseases.

Treatment Options

A doctor’s decisions concerning treatment of biphasic mesothelioma generally depends heavily on the stage and location of the malagnancy. This type of mesothelioma tends to carry a slightly poorer prognosis than epithelioid mesothelioma because of the presence of sarcomatoid or fibrous cells. Those with the biphasic cell type may not be considered for more aggressive treatment plans. Most mesothelioma patients are treated with multimodal methods, incorporating traditional treatments such as surgery, chemotherapy, and radiation. Still others may look into alternative and complementary methods and medicines.

Learning more about specific subtypes of mesothelioma, such as biphasic, and their coordinating diagnosis, characteristics, and treatment options assists patients and doctors in making more informed decisions concerning their cancer.


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