Biphasic mesothelioma is a combination of epithelioid and sarcomatoid cells. A patient’s prognosis heavily depends on the ratio of epithelioid to sarcomatoid cells.
What is Biphasic Mesothelioma?
Characteristics of Biphasic Cells
Biphasic mesothelioma is the second most common diagnosis. Biphasic mesothelioma makes up about 30 percent of all cases.
Cell Type Description
Biphasic diagnoses have a combination of epithelioid and sarcomatoid cell types. This means the patient’s prognosis depends on which cell is more prevalent. More epithelioid cells equal a better prognosis.
The behavior of a biphasic diagnosis is dependent on which cell type is more prevalent.
Diagnosing Biphasic Mesothelioma
Doctors use a technique called immunohistochemistry to diagnose biphasic mesothelioma. This process coats the cells with dye so that the proteins within the cells are more visible and can be identified. These proteins are used as markers to detect if cancer is present. Mesothelioma specialists are extremely important for diagnosis in patients with a biphasic cell type because treatment can vary depending on whether the tumor is more epithelioid or more sarcomatoid.
It is important that patients receive a correct diagnosis so they may receive specialized treatment.
An Australian study compared 83 patients with pleural mesothelioma, 19 of which had a biphasic cell type. Of those 19 patients, 11 were initially diagnosed with epithelioid mesothelioma, 5 were told they had biphasic mesothelioma and 3 were not given an original diagnosis.
These patients were studied to see if they were eligible for extrapleural pneumonectomies (EPP). An EPP is most effective when performed on patients with epithelioid mesothelioma.
The second round of diagnoses showed that some patients were being misdiagnosed, and therefore, were not considered for an EPP.
It is important for a patient to receive a correct diagnosis to get the best treatment possible. If a patient is initially diagnosed with biphasic mesothelioma and it is later found that they have epithelioid mesothelioma, they may not be considered for different treatment options or clinical trials shown to help stop metastasis.
Extrapleural pneumonectomies are not usually performed on patients with biphasic mesothelioma because many clinicians believe only patients with epithelioid subtypes are eligible for an EPP.
Mesothelioma patients should always consider getting a second opinion for the reasons above. Get in touch with a specialist for a second opinion using our free Doctor Match program.
There have been cases of epithelioid biphasic mesothelioma patients living longer than the average survival rate. However, these patients were shown to have led a healthy life before their diagnosis and their cancer was caught in Stage 1.