Overview
Biphasic tumors contain a mix of epithelioid and sarcomatoid cells. Your prognosis depends on the ratio. More epithelioid cells mean better treatment options and longer survival times.
Characteristics
- Contains both epithelioid and sarcomatoid cells
- Must have at least 10% of each cell type
- Cell types may be intermixed or in separate regions
- Behavior varies based on dominant cell type
- Prognosis correlates with epithelioid percentage
- Requires careful pathological examination
Subtypes
Epithelioid-dominant
More than 50% epithelioid cells; better prognosis
Sarcomatoid-dominant
More than 50% sarcomatoid cells; poorer prognosis
Balanced
Roughly equal proportions; intermediate prognosis
Diagnosis
Accurate cell type identification is critical for treatment planning. Diagnosis typically involves:
- Large tissue sample needed to identify both cell types
- Pathologist must examine multiple tumor sections
- Immunohistochemistry helps identify each component
- Cell type ratio should be documented
- Small biopsies may miss one cell type
Treatment Options
Treatment for biphasic mesothelioma may include:
- Treatment approach depends on dominant cell type
- Surgery may be considered if epithelioid-dominant
- Chemotherapy response varies by cell composition
- Immunotherapy may benefit some patients
- Treatment plan individualized based on pathology
Prognosis
If your tumor is mostly epithelioid (over 50%), your prognosis is closer to pure epithelioid cases. Surgery and aggressive treatment may be worthwhile. Higher sarcomatoid content means a tougher road.
Learn about mesothelioma prognosis factors →Getting a Second Opinion
Because cell type significantly affects treatment options and prognosis, obtaining a second opinion on your pathology results from a mesothelioma specialist is often recommended. Pathologists with mesothelioma experience are more likely to accurately identify cell type, subtypes, and any unusual features that may affect your treatment plan.