Cancer Information

Mesothelioma Pathology  

Mesothelioma can be classified under three major histological types:

  • Epithelial or tubulopapillary, the most frequent (50 to 70% of cases)

  • Mesenchymal or fibrosarcomatous, the least common (7 to 20% of cases)

  • Mixed or biphasic, intermediate in frequency (20 to 35% of cases). The mixed type is the most characteristic, containing both epithelial and mesenchymal elements

  • A remarkable property of the mesothelial cell is the production of hyaluronic acid

Signs and Symptoms

The onset of mesothelioma is usually insidious; a common presenting symptom is persistent localized pain.

 Pleural Mesothelioma

  •   Varying degree of chest pain or dyspnea.

  •  Pleural effusion is present initially in up to 95% of cases.

  •  Later, tumor growth usually results in complete obliteration of the pleural space and encasement of the lung.

  • Cough, weight loss, and fever are not uncommon. Clubbing of fingers is seen in only few cases.

  • Mediastinal invasion results in dysphagia, phrenic nerve paralysis, pericardial effusion, and superior vena cava syndrome can occur. Spontaneous pneumothorax or hydropneumothorax and Horner's syndrome (ptosis, pupillary miosis and facial anhidrosis) can some time occur

  • Progressive invasion of the chest wall often leads to intractable pain.

  • Median survival is about 10 to 17 months from onset of symptoms and 9 to 13 months from diagnosis. 5-year survival probabilities is just 3%.

Peritoneal Mesothelioma

  • Pain and abdominal distention with ascites are almost constant in patients with peritoneal mesothelioma.

  • Other clinical findings include nausea and vomiting, bowel obstruction

  • Abdominal and pelvic masses, edema of the lower extremities, fever, hernia, hydrocele, and obstructive uropathy.

  • Median survival is about 10 months from onset of symptoms and 7 months from diagnosis.