Sarcomatoid cell types are mainly found in pleural mesothelioma patients. It is the rarest form of mesothelioma and least treatable.

What is Sarcomatoid Mesothelioma?

Sarcomatoid cells metastasize faster than other mesothelioma cell types, causing the formation of cancerous tumors in other areas of the body. This makes sarcomatoid the most dangerous cell type, though new treatments are leading to longer life expectancies. Sarcomatoid mesothelioma only accounts for about 10-20 percent of all mesothelioma diagnoses.

Characteristics of Sarcomatoid Cells

  • Cell Description

    The cells are spindle-shaped and have an enlarged, elongated nucleus. These cells sometimes have multiple nuclei and are harder to distinguish from healthy tissue.

  • Cell Behavior

    Sarcomatoid cells do not bundle themselves in a uniform way like epithelioid cells. This contributes to the cells’ ability to spread faster than other cell types.


Sarcomatoid Mesothelioma Cell TypeSarcomatoid cell types are found in 10-20 percent of pleural mesothelioma and in 4 percent of peritoneal mesothelioma diagnoses. They are also found in bladder, kidney, lung, and liver cancers.

The diagnosis of sarcomatoid mesothelioma is difficult because of the similarity to benign tissue cells. Sarcomatoid mesothelioma is commonly misdiagnosed as fibrous pleurisy, fibrosarcoma, and metastasized renal cell carcinoma.

Knowing the symptoms of the disease can prepare patients for what to expect. Symptoms get more intense as tumors begin to spread. Below are some general symptoms of sarcomatoid mesothelioma.

Symptoms of sarcomatoid mesothelioma of the pleura include:

  • Weight loss
  • Fatigue
  • Shortness of breath
  • Difficulty breathing

Symptoms of sarcomatoid mesothelioma of the peritoneum include:

  • Loss of appetite
  • Nausea
  • Pain of the abdomen
  • Swelling

Since sarcomatoid cells are so hard to differentiate from other cell types, doctors use a process called immunohistochemistry. This process is a tissue staining technique that makes proteins in the cell samples more visible under a microscope.

Subtypes of Sarcomatoid Mesothelioma

Transitional Mesothelioma

  • Behaves like standard sarcomatoid cell types
  • Plump, spindle-shaped

Lymphohistiocytoid Mesothelioma

  • Contain a large amount of inflammatory and immune cells (1% of all diagnoses)
  • Large, spindle-shaped

Desmoplastic Mesothelioma

  • Difficult to diagnose, patternless (5% of all diagnoses)
  • Long and collagen bundles


Treatment for sarcomatoid cell types is difficult because it is the most aggressive cell type of mesothelioma. Although surgery, chemotherapy, and radiation are the treatment options most used with sarcomatoid mesothelioma, surgery can be difficult.

Sarcomatoid mesothelioma is very rigid when it attaches to the chest wall and it is difficult to remove. In peritoneal mesothelioma instances, the tumor cases around the intestines which also makes it harder to remove.

Although chemotherapy does not show as much success in shrinking tumors, there have been new discoveries made. Researchers have discovered that a drug called doxorubicin works effectively on its own and when combined with other chemotherapy drugs.

Sarcomatoid mesothelioma is difficult to treat, but with new advances, researchers hope to see survival rates increase over the next few years. Get connected with a mesothelioma specialist who can help improve your survival rate.


The prognosis for sarcomatoid cell mesothelioma is not as positive as other cell types. The median survival rate for patients is around six months. However, there have been patients that have survived up to six years past their initial diagnosis date. Patients with lymphohistiocyoid mesothelioma have the best prognosis.

A patient’s prognosis is largely dependent upon available treatment options and the cancer’s stage at discovery. Every prognosis, no matter how dire, has had cases of survival. There have been survivors living with mesothelioma for 5+ years after a sarcomatoid mesothelioma diagnosis.

Learn how survivors beat the odds in our free Mesothelioma Survivor’s Guide.