What is desmoplastic mesothelioma?

Desmoplastic mesothelioma is a cell subtype of mesothelioma. This aggressive variant of sarcomatoid mesothelioma often occurs in the pleura surrounding the lungs and sometimes in the abdomen (peritoneum). Around five to ten percent of mesothelioma patients have this type of cancer. Its cells are often described as bland or patternless in appearance and are usually found after the cancerous cells have invaded the chest wall.

How is desmoplastic mesothelioma diagnosed?

As with any form of mesothelioma, a doctor usually orders a biopsy for testing. The goal of the biopsy is to collect a large sample of tumor tissue for testing because the fibrous regions of sarcomatoid mesothelioma tumors can hide cell variations necessary for a desmoplastic diagnosis.

The presence of the dense cell fibers in all pleural mesothelioma tumors, in general, makes it difficult for doctors properly to diagnosis desmoplastic mesothelioma, so misdiagnosis is common. The disease is often misdiagnosed as fibrous pleurisy, pleural fibrosis, rheumatoid disease or spindle cell sarcoma.

Doctors look for the following criteria when a patient is suspected of having the disease:

  • At least 50 percent of the tumor consisting of dense fibrous tissue that frequently forms nodules
  • Areas of increased cellularity with sarcomatoid mesothelioma characteristics
  • Specific areas of cell death, known as necrosis, seen in 70 percent of cases
  • Spread of neoplastic spindle cells to the lung or chest walls
  • Metastasis to nearby fat tissue, skeletal muscle or lungs
  • Presence of the p53 tumor suppressor gene protein

Symptoms and treatment of desmoplastic mesothelioma

The symptoms vary, depending on the cell type. The most common symptom of desmoplastic mesothelioma is chest pains caused by fluid buildup in the lungs. Often, this is the only symptom experienced by patients.

Treatment for desmoplastic mesothelioma is typically palliative — striving to reduce symptoms, prolong survival and improve quality of life. Treatments can also include chemotherapy and radiation to shrink tumors and kill cancerous cells. After diagnosis, the average life expectancy of patients is only about one year.

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