One subtype of epithelial, or epithelioid, mesothelioma is known as adenomatoid mesothelioma. It’s also called glandular mesothelioma. This type of mesothelioma involves cells of the epithelial type, but which are also classified as adenomatoid, or arising from the mesothelium of any of the glands in the body. Glands are the small organs that produce and release hormones, and include the testis, pituitary gland, and pancreas.
Adenomatoid tumors most often originate in the genital glands of male or female patients and are often benign. They can, however, become malignant, and metastasize to the pleura. Some cases of malignant pleural mesothelioma have also been found to have growth patterns characteristic of adenomatoid tumors. Because this type of cell growth can be either malignant or benign, diagnosing malignant forms of the cancer is difficult, but important for treatment.
An adenoma, or adenomatoid tumor, is a benign tumor that arises in the epithelial cells of a gland, such as the prostate or testis. These tumors may also arise in non-glandular tissues, but when they do, they show signs of gland-like cell patterns and growth. Some of the most common areas of the body in which adenomas originate include the genital tracts of both men and women. Many of these tumors show signs that they include tissue from the mesothelium, but others do not. Adenomas, therefore, may or may not be classified as mesothelioma.
When an adenomatoid tumor transitions from benign to malignant, it is called an adenocarcinoma. This type of tumor can spread, or metastasize to other organs in the body, including the pleura. Mesothelioma in the pleura that has adenomatoid cells may be the result of metastasized adenocarcinoma. In other words, the cancer began elsewhere and spread to the pleura.
Pleural Adenomatoid Mesothelioma
If the adenocarcinoma found in the pleura did not originate somewhere else and metastasize there, it is considered to be an adenomatoid mesothelioma, or a true mesothelioma that originated in the pleura, and that has characteristics of adenomatoid, or glandular, cancer cells. The growth pattern of this type of mesothelioma is of tubular spaces that are lined with epithelial cells. This looks very much like the pattern seen in benign adenomas and malignant adenocarcinomas.
Because adenomatoid cells in mesothelioma may originate in various ways, it can be tough to diagnose. The malignant cells mimic those that are benign and it can also be difficult to tell if the cells originated as an adenocarcinoma and spread to the mesothelium, or if they originated in the pleura or other part of the mesothelium and is a true mesothelioma.
Diagnosis begins as with any case of potential mesothelioma: a physical exam and description of the typical symptoms, imaging scans, and biopsies. These techniques can all help a doctor make a diagnosis of mesothelioma, but histological study, or examination of the tumor and fluid cells under the microscope is crucial to diagnose the specific type of mesothelioma.
Since the cell structure and growth pattern of adenomatoid mesothelioma mimics other types of tumors, basic histological study of biopsied samples is not always enough. Studies have found that immunohistochemical staining and examination can distinguish between cells that originated in the mesothelium and those that metastasized from elsewhere or are benign. This type of staining uses specific antibodies to target the cellular components that are characteristic of a type of cell, like a mesothelial cell. With this type of diagnostic tool, doctors can determine cell type much more accurately.
If adenomatoid cells found in the tumors of the pleura or other part of the mesothelium turn out to be benign, treatment is fairly straightforward. Surgery is generally used in these cases to remove the tumor and to prevent further growth of the abnormal cells. If it is a true malignant mesothelioma the treatment is much like other types of this cancer: a combination of surgery, chemotherapy, and radiation are usually used to try to reduce or completely remove tumors.
Unfortunately, the prognosis for most cases of adenomatoid mesothelioma is not positive. Most of these end up being malignant and are just as tough to treat as other types of malignant mesothelioma. In one study, participants being studied for adenomatoid mesothelioma tumors received treatment, but only lived an average of ten months after the initial diagnosis.
As with other types of mesothelioma, adenomatoid mesothelioma is strongly correlated with asbestos exposure. If you have been diagnosed with any type of mesothelioma and you believe asbestos played a role in your illness, you may have the ability to sue and seek compensation.
Page edited by Dave Foster
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