Mesothelioma by Cell Type
Mesothelioma is classified by cell type and by where you have it. If it's in the lungs then it is called Pleural mesothelioma. If it's in the abdomen, then it is called Peritoneal mesothelioma.
Pleural Mesothelioma is the much more common of the two and up to 80% of all cases of mesothelioma are diagnosed as pleural.
Mesothelioma by Cell Type
Mesothelioma is also often classified by looking at how the cells appear under a microscope. When mesothelioma is grouped this way, there are 3 types known as:Epithelioid, Sarcomatoid or fibrous and Mixed type (also called Biphasic type)
Around 70% of mesothelioma diagnosed are epithelioid.
Around 20% of mesothelioma diagnosed are sarcomatoid type and up to 35% of mesothelioma diagnosed are found to be mixed, having both epitheloid and sarcomatoid cells.
These types of mesothelioma cells can then be further divided into other types of cancerous cells called Clear cell, Small cell, Acinar cell and Tubopapillary cell.
Because there are so many different cell types which can develop in mesothelioma it makes mesothelioma diagnosis very difficult.
Pleural Mesothelioma Investigations
If you present to your gp with some or all of the symptoms of pleural mesothelioma, then he will use several guidelines to determine whether or not you require further testing.
Obviously, since mesothelioma has so many symptoms and is such a rare disease it can be hard for a gp to decide whether or not you may have the illness. The first course of action is to assume that you are suffering from something much more common and either likely to right itself or to respond to medication such as antibiotics. Unless you know you have definitely been exposed to asbestos then your gp will probably treat you as having something less rare.
However, some particular symptoms do require you be seen by a specialist immediately and NICE (The National Institute for Health and Clinical Excellence) have produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist.
If you have some symptoms of pleural mesothelioma then NICE recommend you be referred for an urgent chest x-ray. If this x-ray shows anything abnormal, then you will receive an appointment to see a specialist, preferably within two weeks of speaking to your GP.
Unfortunately, as yet there are no published guidelines for seeing a specialist if you have peritoneal mesothelioma.
Urgent chest X-ray
If you have been exposed to asbestos or other mesothelioma risks in the past and you are suffering any of the symptoms of pleural mesothelioma, then you should be sent for an urgent x-ray to determine the cause of the problems.
If you have started getting new pains in your chest, you are finding breathing increasingly difficult or you have unexplained symptoms such as shoulder pain, a copugh or weight loss that lasts beyond three weeks, then you must get an x-ray at the earliest possible chance.
Guidelines for Urgent Referral
The Department of Health guidelines suggest if you are deemed to require an urgent referral to see a specialist that you get an appointment within 2 weeks. You should see a specialist if you have recently developed chest pain and shortness of breath and you have a history of having been exposed to asbestos or other mesothelioma risks.
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