Biphasic Mesothelioma Diagnosis, Cell Types, Treatment & Prognosis

Biphasic Mesothelioma: Patients suffering from mesothelioma often have to go through a number of stages depending on their advancement levels. One such common condition is called biphasic mesothelioma which is actually a cancer caused by the asbestos exposure.

biphasic mesothelioma

There is another form known as malignant biphasic tumor that basically contain a combination of sarcomatoid and epithelioid cells. Patients suffering from biphasic mesothelioma show symptoms like pleural effusion, shortness of breath and a dry cough.


What Is Biphasic Mesothelioma?

Biphasic mesothelioma is a form of mesothelioma which is known to have a combination of epithelial and sarcomatoid cells.

It's no way different than any other type of mesothelioma which is caused due to the asbestos exposure. In most cases of mesothelioma, asbestos exposure becomes the leading cause of the disease.

Considering the life expectancy of patients suffering from biphasic mesothelioma, it actually differs from patient to patient. In general, the life expectancy of such patients varies. It depends on the ratio of sarcomatoid and epithelial cells.

The larger the percentage of sarcomatoid cells, the poorer the prognosis. The above cell type is mostly found in pleural patients as compared to peritoneal patients.

Biphasic cell type happens to be the most common mesothelioma cell types we have seen. Take a look at three different mesothelioma types on the basis of their cell types.


Epithelial mesothelioma: Also known as epithelioid is the most common and treated easily

Sarcomatoid mesothelioma: This cell type accounts for 10% to 20% of cases and is found more resistant to the treatment given

Biphasic mesothelioma: It mainly depends on the ratio of both type of cells


Now, if you wish to understand the characteristics of all the above mesothelioma types, you need to first understand their cell types.

Also Read: Sarcomatoid Mesothelioma Treatment, Diagnosis Survival and Sub types


Biphasic Mesothelioma Characteristics

One peculiar characteristic of biphasic mesothelioma is that both sarcomatoid cells and epithelioid cells are able to exist close together. Not only that they can also appear within separate areas of tumor.

For example, areas of epithelioid cells generally composed of tubopapillary (epithelial subtypes) and sold cells are generally found scattered among sarcomatoid cells. Due to this, you will find the proportion of both these cell types to vary in great amounts.

Cell Behavior and Prevalence

In such type of medical ailments, incidence rates generally show close to 30% of pleural mesothelioma tumors while 25% peritoneal tumors are found to be biphasic.

But a number of pathologists say that the cell prevalence of biphasic mesothelioma would go higher if there are more areas of mesothelioma tumors are sampled and analyzed.

Please note that pathologists are medical practitioners who have to study about the disease causing pathogens so as to get the diagnosis of the condition. And so, they have to review various biopsies to come to a conclusion.

The cell type and behavior of biphasic mesothelioma are the final determining factors that depend on which cell type is more prevalent.


How to Diagnose the Biphasic Cell Type

In general, it becomes a challenge to detect and diagnose biphasic mesothelioma cell type.

In order to give a direct and efficient treatment, it's important to detect the particular mesothelioma cell type that exists. Now, the characteristics of the cell type don't affect the mesothelioma symptoms. However, they may affect the life expectancy of a patient.

As per a report published in Lung Cancer International, patients with epithelial mesothelioma cell types survived 200 days longer as compared to the other cell types.

The cell type is diagnosed after biopsy where a small tissue is taken to study in the lab. As per a recommended practice, doctors have to take tissues pertaining to different locations to reach out better results instead of taking them from a single location.

And so, determining specific cell type is a crucial step towards the diagnostic process as it can directly affect treatment option and prognosis.


How to Prevent A Misdiagnosis?

In order to treat biphasic mesothelioma, doctors make use of advance tests like immunohistochemistry. The above test is generally used to spot biphasic mesothelioma from other medical ailments that can be easily confused with this cancer.

The above technique is used to detect some special type of proteins, revealing certain types of abnormal cells. And so, doctors are able to rule out some of the most common misdiagnoses like carcinosarcoma and synovial sarcoma.

The initial diagnostic method used to detect biphasic mesothelioma involves a combination of methods like computerized tomography, thoracotomy, thoracoscopy and more.


Biphasic Mesothelioma Treatment

Those with biphasic mesothelioma cell type are not considered to go through an aggressive treatment plan as compared to patients with epithelioid cell type.

The reason for this is that biphasic cell type carries somewhat lesser prognosis as compared to epithelioid. However, treatment for both these cell types varies and is not completely based on their cell types.


The treatment involves one of these therapies given below:

  • Surgery
  • Chemotherapy
  • Radiation


In most cases, treatment will depend on the location and stage of the tumor rather than the involvement of the cell type.

With the advancement of technology towards medical treatment, various clinical trials are testing new drugs for sarcomatoid or biphasic tumors as well as other mesothelioma patients.


Biphasic Prognosis & Life Expectancy

The prognosis for biphasic mesothelioma varies (as stated earlier) depending on the ratio of sarcomatoid and epithelial cells in each case.

In general, larger the amount of epithelial cells a patient has in a biphasic mix, the better the prognosis.

There are various studies conducted to know about the average life expectancy of biphasic mesothelioma patients. In one such study conducted that involved over 85 pleural mesothelioma patients. All of them had a variety of cellular subtypes.

It was found that those with biphasic cell type had an average survival of about 15 months. Also, patients with epithelial subtype registered the highest survival rates which were more than 22 months.

Scientists and researchers have therefore observed a much better survival rates among patients with biphasic cell type as compared to those having a majority of epithelial cells. The last category of patients was having mostly sarcomatoid cells.

It was also seen during treatment that sarcomatoid cells were less responsive to treatment than epithelial cells. This is why biphasic patients having a lower amount of sarcomatoid cells tend to witness better results to the treatment given.

Please note that epithelial cells in the biphasic tumors most likely contribute to the one moth survival average as observed in the biphasic patients.

Another crucial thing to be noted down is that biphasic tumors having a high ratio of sarcomatoid cells tend to spread quicker. And this leads to their shorter life expectancy rates.



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