Mesothelioma Cell Types

Doctors classify cases of mesothelioma into one of three main cell types, depending on which cells make up tumors. These mesothelioma cell types are epithelioid, sarcomatoid, and biphasic. Your cell type greatly affects your prognosis (health outlook) and treatment options. Lung Cancer Group may be able to help you access treatments and compensation no matter which mesothelioma cell type you have.

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Written and Fact-Checked by: Lung Cancer Group

Last updated: July 3, 2024

What Are the 3 Types of Mesothelioma Cells?

There are three major histological (cell) types of mesothelioma.

Malignant mesothelioma cell types include:

Epithelioid mesothelioma: This is the most common cell type and the easiest to treat. Epithelial mesothelioma accounts for about 70% of cases, according to the UPMC Hillman Cancer Center.
Sarcomatoid mesothelioma: This mesothelioma cell type is the rarest and hardest to treat. It makes up 10-20% of mesothelioma cases, as noted by the American Cancer Society (ACS).
Biphasic mesothelioma: When a tumor has both epithelial and sarcomatoid cells, it’s considered biphasic. Between 20-30% of cases fall under this type, according to the ACS. It’s easier to treat if there are more epithelioid cells than sarcomatoid ones.

Oncology (cancer) doctors can determine which mesothelioma cancer cell type you have when making a diagnosis using a biopsy, where a fluid/tissue sample is reviewed under a microscope.

After confirming you have mesothelioma and the specific cell type, your doctors can recommend a treatment plan that will best fit your needs.

We have on-staff mesothelioma nurses who can help you understand the best treatments for your cell type. Speak with a nurse to find the care you need.

Epithelioid Cells

Malignant epithelioid mesothelioma can develop when healthy epithelial cells, which line the body’s surfaces and cavities, are exposed to asbestos.

Epithelial mesothelioma cells are shaped like cubes or ovals when seen under a microscope. They multiply rapidly but stick together, meaning they don’t spread as quickly and are easier to treat than the other mesothelioma cell types.

Epithelioid Mesothelioma Prognosis

Patients with epithelioid malignant mesothelioma typically have the most favorable prognosis compared to the other cell types.

Mesothelioma prognosis is measured by:

Life expectancy: The median epithelioid mesothelioma life expectancy is 14 months with treatment.
Survival rate: This is the percentage of patients who are still living after a set period of time. The 2-year epithelial mesothelioma survival rate is 45% and the 5-year survival rate is 14% when treated with surgery, according to a 2023 report from Cancer Medicine.

“If it’s a case of epithelioid mesothelioma, it’s treated better, for lack of a better word.”

— Amy Fair, RN, 20+ years helping mesothelioma patients

Unique patient factors such as where mesothelioma tumors form in the body, the stage, and more all play a role in a patient’s epithelial prognosis. Surgery, chemotherapy, radiation, and other treatments could all help patients live longer.

Call (877) 446-5767 now for help improving your epithelial mesothelioma prognosis by working with our on-staff registered nurses.

Sarcomatoid Cells

Malignant sarcomatoid mesothelioma cells are polygonal or spindle-shaped. They spread faster than epithelioid cells, since their shape prevents them from clumping together.

Their shape also makes metastasis (cancer spread to other parts of the body) more likely since the cells won’t stick to a patient’s main tumors easily, according to the Moffitt Cancer Center.

Sarcomatoid Mesothelioma Prognosis

Since sarcomatoid malignant mesothelioma can spread more easily and is harder to treat, it has the least favorable prognosis of any cell type.

Here are some sarcomatoid mesothelioma survival statistics:

Life expectancy: The average sarcomatoid mesothelioma life expectancy is 4 months.
Survival rate: A 2023 Cancer Medicine review found that the 2-year sarcomatoid mesothelioma survival rate is 15% and the 5-year survival rate is 4% when treated with surgery.

Getting sarcomatoid mesothelioma treatments like surgery and chemotherapy is the best way for you to live longer with this cancer.

Speak to a nurse to get help connecting with top health care specialists and treatments for all mesothelioma cell types.

Biphasic Cells

Biphasic mesothelioma cancer tumors consist of both epithelial and sarcomatoid cells.

There can be more of one cell type than another in biphasic tumors, and this affects a patient’s health outlook. If a biphasic tumor has more epithelial cells, it’s easier to treat.

“When Jimmy got out of the hospital and we came back for our post-op, our doctor said it was biphasic mesothelioma, meaning you got not just one cancer cell type but two cancers. It was a ratio of 70 to 30, and it was 70 to the bad.”

— Kelley, wife of biphasic pleural mesothelioma patient Jimmy

Biphasic Mesothelioma Prognosis

Biphasic malignant mesothelioma has a better prognosis than sarcomatoid mesothelioma, but a worse one than epithelial.

Biphasic prognosis is measured using:

Life expectancy: The average life expectancy for biphasic mesothelioma patients is 10 months, according to an F1000 report.
Survival rate: The 2-year biphasic mesothelioma survival rate is 22% and the 5-year survival rate is 5% when patients receive surgery, as noted by a 2023 Cancer Medicine data review.

Which mesothelioma cell type is more prominent, where the cancer tumors formed, and how far they’ve spread all play a role in how long you’ll live with this cancer.

Contact us now to get advice on doctors and treatments for biphasic mesothelioma or any other mesothelioma cell type. We stand ready to assist you in any way we can.

Rare Mesothelioma Cell Types

In some cases, your doctor could find that you have a subtype of epithelial or sarcomatoid mesothelioma. These rare mesothelioma cell types may significantly affect your prognosis.

Rare mesothelioma cell types include:

Adenomatoid: This subtype appears in 5% of pleural mesothelioma cases (which develop in the lining of the lungs, called the pleura). These mesothelial cells have lace-like patterns when viewed under a microscope.
Cystic: This type usually develops in cases of epithelioid peritoneal mesothelioma (which forms in the peritoneum, the lining of the abdomen). They are usually benign (non-cancerous).
Deciduoid: This type of epithelioid mesothelioma makes up less than 5% of all cases. Its overall prognosis is poor, with a 1-year mortality rate of 68%.
Desmoplastic: This is a subtype of sarcomatoid mesothelioma. Desmoplastic mesothelioma accounts for 5-10% of pleural mesothelioma cases and has a poor prognosis.
Lymphohistiocytoid: This is a very rare epithelial mesothelioma subtype, making up less than 1% to 3.3% of cases. Doctors must avoid misdiagnosing patients with other cancers that look similar under a microscope, like lymphoma.
Small cell: Small cell mesothelioma is a very rare epithelioid subtype and could be mistaken for small cell lung cancer if doctors aren’t careful.
Well-differentiated papillary: This epithelioid subtype typically develops in women and it’s often benign.

If you suspect you may have mesothelioma, see a specialist who treats this cancer. Top doctors can help determine your diagnosis and recommend the best treatments for your case — even for rare mesothelioma cell types.

How Doctors Determine Mesothelioma Cell Types

Doctors determine mesothelioma cell types through histology, the study of cancerous cells.

Steps to find cell type through mesothelioma histology include:

Biopsy removal: Doctors take a sample from the tumor or fluid that is suspected to be cancerous through a biopsy.
Pathology review: Your doctor will send the biopsy sample to a pathologist, another doctor who specializes in reviewing cells. They will look at it under a microscope to determine which mesothelioma cell type (if any) you have.
Receive results: After the pathologist has the results, you and your doctor will review them. At this stage, you may be referred to a mesothelioma specialist or if you’re already working with one, start a treatment plan.
Second opinion: If you want to be certain that you received an accurate mesothelioma diagnosis, you can request a second opinion. You may have another biopsy sample reviewed or have your original one examined by a different pathologist.

Speak to our mesothelioma nurses now — they can help you or a loved one find doctors to determine mesothelioma cell types and get the treatments you need.

We’re Here to Assist Patients With Any Mesothelioma Cell Type

Lung Cancer Group was founded so anyone with asbestos-related diseases, including mesothelioma or lung cancer, can get assistance navigating life after a diagnosis.

To that end, our skilled registered nurses and patient advocates are standing by to help in any way they can — no matter which mesothelioma cell type you have.

Work with our team to:

Find top mesothelioma doctors and hospitals near you
Learn which treatments will work best for your cell type
Pursue financial compensation to cover expenses

Don’t wait: Call (877) 446-5767 or connect with us to speak with a mesothelioma nurse now.

Mesothelioma Cell Types FAQs

What cell type is mesothelioma?

There are three types of mesothelioma cancer cells: epithelioid, sarcomatoid, and biphasic. Epithelioid cells are oval or cube-shaped. They’re the most common and easiest to treat.

Sarcomatoid cells are shaped like spindles and are very hard to treat. This type is the least common. Biphasic mesothelioma tumors contain both of the other types. If more epithelial cells are present, they may be more responsive to treatments.

Call (877) 446-5767 now to get help from our registered nurses for all mesothelioma cell types.

What type of cell is the mesothelium?

The mesothelium, which is the body’s internal lining, is made up of epithelial cells. These cells can mutate into different mesothelioma cell types 10-50 years after asbestos exposure.

At this time, doctors don’t fully understand how specific mesothelioma cell types develop. The only fact that’s certain is that asbestos can cause all types of mesothelioma.

Is mesothelioma a small cell cancer?

This depends on the cell type present. In rare cases, some patients may have small cell mesothelioma, which looks similar to small cell lung cancer under a microscope.

Mesothelioma is not a type of lung cancer, though — lung cancer forms directly in the lungs, while mesothelioma can form in the linings of the lungs, abdomen, heart, or testicles. Both cancers require different treatments and have unique prognoses (health outlooks).

Why does mesothelioma cell types matter?

The cell type of malignant mesothelioma matters because each has its own prognosis and responds to treatments differently.

Sarcomatoid and sarcomatoid-dominant biphasic mesothelioma tend to have lower life expectancies, while epithelioid mesothelioma cells are more easily treatable, so patients might live longer.