Sarcomatoid Mesothelioma Symptoms, Diagnosis and Treatment
Sarcomatoid Mesothelioma- Before updating you with the term
Sarcomatous mesothelioma, we would first like you to understand the term. The
term is also known as Sarcomatoid plural mesothelioma which is actually the
state of an advanced mesothelioma.
The main reason why it is one of the dreaded forms of lung tumor is due to the fact that it is formed by a lot of sarcomatoid cells located in the linings of lungs (plural membrane or pleura).
The fact that it is called as the
least common type of mesothelioma can be evident by the fact that it can affect
the line of treatment as well as prognosis.
We have already explained you above
that this kind of mesothelioma is an advanced type which is characterized by
sarcomatoid cells. As per the findings in this regard, it has been estimated
that close to 20% such cases have the presence of sarcomatoid cells that have
the capability to grow at an alarming rate.
More than that, these kind of cells
are quite specialized ones that are quite resistant to the different treatment
options as compared to the other mesothelioma cell types. And this pose
somewhat high difficulty levels to control such kind of tumors in the long
run.
How Sarcomatous Mesothelioma Looks Like
As the name relates, they are made up
of Sarcomatoid cells and are also known by some other names like spindled,
sarcomatous or diffused tumors that are known by another term as malignant
fibrous mesothelioma.
In such kind of tumors, the cells
are organized in an irregular way and take the shape of spindle with plump.
They are also diffused with elongated nuclei.
Most of the times, these specialized
cells take the shape of sarcomatoid tumors and take less time making small
nodules that starts scattering and growing along the surface of the lungs.
There are some rare forms of this
kind of tumor where a single mass of tumor starts growing and most likely
become harder to remove even after embarking surgeries, especially if it has
started growing into the chest wall.
As you can relate yourself, a lot many
complications arise after the growth of such tumors. And one such way it may
create further complexity which is called plural diffusion. But this is not so
common and is not found in the majority of such cases.
Talking about plural effusion, that
happens to be the most common cause and symptom of initial mesothelioma that
mostly accompany chest pain and shortness of breath. In most cases,
these symptoms are not so much severe without the presence of plural effusion.
Other thing to be noted that most
patients who have single mass of tumor growing in their chest wall complain
more significant chest pain as compared to those who experience somewhat sheet
like growth of tumor.
As you might know, all 3 kind of
mesothelioma cell types- epithelial, sarcomatoid and biphasic is capable of
affecting prognosis and treatment. In case, if a patient is diagnosed with
sarcomatoid plural mesothelioma, a patient becomes more likely not to respond
to the treatment.
This generally results in shorter and
fewer treatment options and the survival rate also becomes lesser. However, if
a patient develops such kind of growth at an early stage, he can have a lot
more treatment options available that can be far more effective than above.
Diagnosis of Sarcomatous Mesothelioma
This kind of tumor is quite
difficult to diagnose as they generally resemble benign and other kinds of
malignant conditions.
Due to this, initial flaws are likely
to happen and disrupt the route treatment along with their proper diagnosis. If
you look their cells under microscope, you can see them growing just like other
most common localized sarcoma tumors of the plural membrane.
Now, please take a look at some of
the most common misdiagnoses for sarcomatous mesothelioma that generally include:
- · Fibrous pleurisy
- · Fibrosarcoma
- · Pleural liposarcoma
- · Localized fibrous tumours
- · Metastasized renal cell carcinoma
Best Practice to Test Sarcomatous Mesothelioma
As we have already covered that it is
quite necessary to properly investigate this kind of mesothelioma which is
possible only after conducting a series of vital tests.
The first step is to conduct an
imaging test like an X-ray, MRI or CT scan. These tests basically help to
identify the tumor visibly without undergoing any kind of hassles.
The next hurdle that comes forth is
to identify the cell type. In order to make a correct diagnosis, a biopsy is
done where a small mass of tumor is taken.
In general, biopsies are done to help
physicians to better understand or closely examine the kind of tissue. In case,
the sample tissue is too small, it becomes even harder to determine the type of
cells associated in the tumor effectively. And this may lead to the initial
misdiagnosis in assessing the kind of tumor.
Immunohistochemistry simply works with
the help of antibodies that basically react with proteins in the sample tissue
taken for biopsy.
This kind of test is quite simple and
can see the result happening in a far less time. The technique is helpful as it
helps in differentiating the tumor type that can readily help in determining
the right line of treatment.
How Sarcomatous Mesothelioma Tissue Behave to the Stain Used in
Immunohistochemistry
In general, the Sarcomatous
mesothelioma tissue doesn't react to the antibody being used in this technique
called Immuno-histo-chemistry. However, a plethora of antibodies like D2-40,
CAM5.2, WT1 and podoplanin will simply mark the presence of sarcomatoid cells.
In the same ways, these specific antibodies also stain negatively for other
kind of tumors that look quite similar with the sarcomatoid tumours.
Why the Initial Diagnosis id Tough?
As you can see how the tumor
containing sarcomatoid tissue behave to the stain used in the above technique,
you can expect how difficult it is to properly diagnose the above anomaly.
The procedure of diagnosis also
becomes hard due to the presence of as many as 3 variations of Sarcomatous
mesothelioma that are desmoplastic, transitional and lymphohistiocytoid.
All three kind of variants are loaded
with entirely different cell structures that make it tough to make a definitive
and proper diagnosis.
Symptoms of Sarcomatous Mesothelioma
Now, take a look at the symptoms of
Sarcomatous mesothelioma
Transitional Mesothelioma - Well, it's quite peculiar in shape by having spindle and
plump shaped cells, instead of spindle shaped cells with plump along with
elongated nuclei.
Desmoplastic Mesothelioma- This category happens to be one of the most difficult
subtypes to diagnose. Also, it accounts to almost 5% of entire mesothelioma
cases. The difficulty in diagnosing this kind of cell types is that it lacks a
clear and defined pattern. These cell types also contain a plethora of
elongated cells with collagen sheaths (bundles).
Lymphohistiocytoid Mesothelioma- These sub-types consist of even larger and spindle-shaped
cells along with inflammatory and immune cells. These cells generally account
for less than 1% of all such cases.
Effect of Sarcomatoid Cells Towards Prognosis and Treatment of Pleural Mesothelioma
As we have already explained you
above about the kind of aggressiveness of sarcomatoid tumors to the different
line of treatments, one thing that can be affirmed is that such kind of tumors
hardly show response towards different treatment options.
However, the treatment basically
revolves on the stage of mesothelioma along with its location. It simply means
that physicians mainly go ahead with the conventional line of treatments that
include chemotherapy, surgery and radiation therapy.
In case, the diagnosis is delayed,
these sarcomatoid cells become even more resistant to the line of treatment.
How Sarcomatous Mesothelioma Response with Different Line of Treatments
Let’s analyse how the tumor
generally response with all 3 lines of treatments.
Surgery- Well,
these tumors are hard to be treated with surgery as they have a habit of
penetrating to the chest wall. It becomes difficult to remove with surgery as
they become more complicated.
Chemotherapy-
It also have limitations towards treating the tumor.
Any Hope to Deal with Sarcomatous Mesothelioma?
There is a new drug Sodium Selenite
that looks a potent chemotherapy drug suitable for all kinds of
mesothelioma cell types.
As per the research done on this
drug, it has been shown that it has the capacity to cause apoptosis (cell
death), when combined with Doxorubicin (Anthracycline antibiotic). However, it
has not been studied or practiced on humans till date.
As of now, clinical trials for such
kind of mesothelioma looks hard due to its rare diagnosis. In order to deal
with it, a plenty of specialized mesothelioma programs are being organised to
improve the resources and treatment options for patients.
Before patients go for any kind of
treatment, they should first consult mesothelioma specialist before deciding
for the actual line of treatment.
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