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Understanding Malignant Epithelial Mesothelioma

What is the epithelial cell?
Epithelial cells form the epithelium which is that layer of epithelia that cover the inner and outer linings major body cavities and surfaces of blood vessels and organs throughout the body. The histological structure of healthy epithelial tissue will vary depending on its location and function. There are four major tissue types found in the human body and epithelial cells are by far the most prolific. Epithelial cells are the safety shields of the body in other words work as the barrier between the outside world’s contaminants and the body… that includes protection, sensory perception and fluid secretion. The epithelial cells may appear typically egg-shaped, thin and flat, cube- or hexagon-shaped or tall and column-like and have easily visible nuclei.


What is Epithelial Mesothelioma?
Malignant mesothelioma is classified by the type and appearance of the cancerous cells involved into three types of cells, depending on the tissues involved, the epithelioid cell type which is the most common and accounts for about 50 to 70 percent of all diagnoses; sarcomatoid mesothelioma is the rarest, and the mixed type of the disease. Epithelial Mesothelioma is a condition that is formed by epithelial cells. Those Patients with epithelial mesothelioma often have a better survival rate and more treatment options than the other types.
Epithelial Mesothelioma and Asbestos:
The typical healthy epithelial cells which are prevalent in the human body can be at risk of mutating upon their exposure to asbestos. Once asbestos fibers are inhaled, they get trapped in the lining membrane where they remain indefinitely. These hard, crystalline amphibole asbestos, which are inhaled consists of hard, needle-like fibers can cause Mesothelioma. As these asbestos fibers bore through lung tissue over a long latency period vary from 20-50 years causes’ chronic inflammation resulting in malignancy. Epithelial Mesothelioma symptoms are similar to those of other respiratory illnesses, what differs is its history of asbestos exposure which is why a mesothelioma diagnosis is so difficult to make.
How is Epithelial Mesothelioma Formed?
When the epithelial cells are exposed to asbestos and get to turn cancerous, they can take on several visual patterns. The epithelial cells adjust themselves to the asbestos that they get in touch with easier than other cells. Usually they lose uniformity to the square shape of the epithelioid cells and become atypical in appearance forming small tubes or clusters shapes; their shape causes the cells to stick to each other. Epithelioid cells will divide at a faster rate than any other types of mesothelioma-related cells and try to spread. The metastasis process in this type of mesothelioma cells is not as fast as it could be when compared with other cells related to this condition because epithelioid cells lack mobility and adhere closely together. Once epithelial cells become cancerous they are called epithelioid cells. Cancerous epithelioid cells does not spread to distant locations and do not migrate easily like sarcomatoid cells, it spreads to nearby lymph nodes and from there migrate locally via the lymphatic system.
Characteristics of Epithelioid Mesothelioma Cell Prevalence
Epithelioid mesothelioma is derived from epithelial cells, which are cube-shaped cells when they are in their healthy normal conditions. When they mutate (change) to become epithelioid cells /cancerous cells they have these Characteristics features;
Cell Description:
Epithelioid cells have a clearly defined, elongated egg-shape /rectangles or pointed ovoid shapes. Their visible very well defined nuclei make it easier to distinguish this cell type.
Cell Behavior:
Epithelioid cells divide more quickly than other mesothelioma cell types, contributing to faster tumor growth at the original site. However, the cells stick to each other, so that metastases are less common.Epithelioid mesothelioma is the most common diagnosis and has the best prognosis.
Epithelioid mesothelioma tends to be found more often in white men over the age of 45 with a pleural diagnosis.
Defining Characteristics:
Specialists categorize Epithelial mesothelioma into many subtypes, each with its own unique characteristics for a more nuanced understanding on how the mesothelioma will affect a patient’s prognosis and react differently to certain treatment plans.
They all contain epithelioid cells some subtypes are more likely to develop in specific parts of the body, while others are extremely rare; some have different sizes, shapes and structures
Subtypes of Epithelioid Mesothelioma:
The following are technical descriptions of some subtype cell patterns doctors have observed although this subdivision won’t affect the treatment in cases of epithelial mesothelioma but it is meant to help doctors tell mesothelioma apart from similar looking cancers.
Tubulopapillary subtype:
This is one of the most common subtypes of epithelioid mesothelioma. Because of its appearance Doctors may mistake this subtype for other types of tumors that has spread to the pleura.
Adenomatoid subtype:
Adenomatoid mesothelioma, also known as the microglandular subtype, adenoid epithelioid cells may be present 6 percent in all of the types of mesothelioma. It can be difficult for doctors to tell this subtype apart from other tumors, because it mimics other types of tumors.
Solid subtype:
The solid subtype has two patterns: a very mature (well-differentiated) or very immature (poorly differentiated). The mature type is one of the most common cell patterns seen in mesothelioma. The very mature or very immature solid subtype cells of mesothelioma may mimics other types of tumors.
Glandular subtype:
These are cells shaped like glands usually develop in the pleural lining and may mimic other types of tumors.
Deciduoid subtype:
This is a rare sub-category of epithelial pleural mesothelioma that may be caused by factors other than asbestos exposure. Deciduoid subtype is very common in peritoneal (intracellular fluid in the cells), in which the cells are deciduas-like. This type is about 2% to 5% of all mesothelioma cases and accounting for 50 percent of deciduoid mesothelioma cases are in the abdomen. Because it is so uncommon, it is mimic other types of tumors.
Diagnosis of Epithelioid Mesothelioma:
Diagnosis of Epithelial tumors can be tricky, they are often confused with adenocarcinoma breast cancer, and other forms of carcinoma; they closely resemble other cancer cell types, a common type of cancer that affects the lining of internal organs such as the lungs, breasts and colon. The symptoms of epithelioid mesothelioma may include: shortness of breath, chest pain or a buildup of fluid within the lungs (pleural effusions). Once the symptoms of epithelioid mesothelioma are recognized, additional diagnostic tests is needed to confirm the presence of cancer.The usual diagnostic tools using images from CT scans or MRIs cannot identify the epithelial cancer cells. After determining the presence of malignant mesothelioma cells using radiology or pathology examinations, the physician may ask about the present of asbestos history exposure. A biopsy is taken which is still the only way to determine which cell type is present and accurately diagnose epithelioid mesothelioma, a thoracoscopy or similar form of surgical biopsy needs to be performed.The required type of biopsy depends on the type, number, and location of the mesothelioma tumors. A thorascopic surgery or a more extended surgical procedures including tumor removal may be taken.
Thoracoscopy ;
A thoracoscopy is an endoscopic procedure generally used to examine the lungs in pleural mesothelioma patients. The linings of the lungs are reviewed through a camera inserted through a minor surgical incision, may be used to identify the designs of the cells and come out of the condition. Regardless of how the biopsy is acquired, biopsies offer experienced pathologist doctors a way to examine the potentially cancerous cells with histological staining so the cells can be visible to the human eye under a high-powered microscope analyzes tumor samples to distinguish it from other types of cancer.
If cancerous cells are found in the biopsy, an immunohistochemistry process is used to detect proteins called antibodies on the surface of cells of a sample that is taken. These proteins help classify a cancer’s cell type and it is the only way to definitively diagnose epithelial mesothelioma and differentiate it from adenocarcinoma.

Epithelial Mesothelioma Treatment:
Epithelial mesothelioma has a slower spread according to other types and allows more curative treatment options, like surgery or chemotherapy, and more effective and better respond to treatment.
Treatment for epithelioid mesothelioma is often standard for the other types of mesothelioma. Fortunately, epithelioid mesothelioma has better prognosis than other types of mesothelioma thus aggressive therapies are used to slow the progression of the disease.
Common surgeries for epithelioid mesothelioma include:
Extrapleural pneumonectomy (EPP):-this is when the patients is eligible for it, the impacted portions such as plural lining, the entire lung, and parts of the diaphragm and pericardium are removed. This is the most radical type of pleural mesothelioma surgery, and a lung transplant will typically be required to make this work which can significantly increase life expectancy.
Lung-sparing pleurectomy with decortication (P/D)with decortication:—In this case tumors haven’t spread, the pleural lining containing the cancer cells is removed; the lung and other nearby areas are not removed as part of this procedure, so the patient recovers faster.
Cytoreductive surgery:—this is used in some of the most serious cases peritoneal epithelioid mesothelioma and is often combined with HIPEC, after the removal of the tumors which involves putting heated chemotherapy agents inside the peritoneal space to eliminate the root sources that can cause the condition to develop.
Surgery is often combined with radiation therapy and chemotherapy; all are aimed to get rid of any unseen cancer cells and have better prognosis. The Multimodal therapy and alternative mesothelioma treatments rather than Surgery, Chemotherapy and Radiation therapy have also been successes in recent years such as gene therapy, immunological therapy, and variations on chemotherapy and radiotherapy (i.e. photodynamic chemotherapy) and intensity modulated radiation therapy.)
How Epithelial Cells Effect Prognosis and Survival:
Patients diagnosed with epithelioid mesothelioma have better prognosis, they live on average about a year after being diagnosed with the cancer. If the disease is diagnosed early enough at a low stage the patient will have better prognosis…living several years longer. Statistics tell us that 40% to 60 % of all patients with this type of cancer survive for longer than one year post-diagnosis. Less than 25% of all non-epithelioid mesothelioma patients can manage to live past the five-year mark. The prognosis is believed to be in part due to Epithelioid cell types that respond more to treatment than other types…Epithelioid cell mesothelioma is considered the best cell type. Treatment for mesothelioma cancer and related prognosis typically depends on the location, size, and type of tumor more than on the histological type associated with the disease. But because epithelial cells respond better to treatment, patients with epithelioid mesothelioma may be eligible for a more aggressive treatment plan — and receive a more favorable outcome and longer survival than patients with other cell types.


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