Tubulopapillary mesothelioma is a variation of epithelioid mesothelioma, the most common cell type for this cancer. It is characterized by tubules and papillary cell architecture. There is evidence that patients with the tubulopapillary subtype of pleural or peritoneal mesothelioma have a greater life expectancy, but this is not always true.
Mesothelioma Cell Types – Epithelial
There are three main types of mesothelioma as categorized by cell type: epithelial, sarcomatoid, and biphasic, which is a mixture of the other two. Epithelial cells are most common in mesothelioma, accounting for nearly three-quarters of diagnoses.
Tissue containing epithelial cells line many parts of the body, from the throat and skin to most organs. The role they play is in protecting other tissues by providing a barrier.
They are healthy, normal cells that come in a variety of sizes and shapes, but they can become cancerous, as in the case of epithelial mesothelioma.
Epithelial mesothelioma is less aggressive than sarcomatoid. The cancerous epithelial cells spread and grow more slowly than those involved in sarcomatoid mesothelioma.
It is still a very serious type of cancer and one that will spread and metastasize, but patients with this cell type are likely to have a better prognosis.
Tubulopapillary Mesothelioma Is an Epithelial Subtype
There are many subtypes of epithelial cells that can be involved in epithelial mesothelioma. Different shapes and growth patterns characterize each one.
One of the most common epithelial subtypes is tubulopapillary. This type of mesothelioma exhibits cancer cells that grow papillary structures and smaller tubules.
There may also be psammoma bodies—round gatherings or bodies of calcium—seen in biopsies of this type of mesothelioma. The cell structure and growth pattern of tubulopapillary mesothelioma can be mistaken for adenocarcinoma.
Symptoms of Tubulopapillary Mesothelioma
Symptoms of this type of mesothelioma follow the same patterns as most other cell types. Pleural tubulopapillary mesothelioma causes chest pains, difficulty breathing, shortness of breath, coughing, and fatigue.
Patients with peritoneal tubulopapillary mesothelioma usually have abdominal pains, bloating, and gastrointestinal symptoms, like constipation or diarrhea.
Diagnosing Tubulopapillary Mesothelioma
Diagnosing any mesothelioma can be difficult for several reasons. Mesothelioma is rare, so it can often be mistaken for another type of cancer, like lung cancer.
As with other types of mesothelioma, asbestos exposure is the most likely cause, so knowing that a patient has been exposed in the past can help make the diagnosis more accurate.
To diagnose tubulopapillary mesothelioma:
- Doctors perform a complete physical.
- They then use imaging scans, like X-rays, MRIs, and CT scans, to look for causes of symptoms, to rule out other conditions, and to detect any unusual growths that may be tumors.
- If they find a growth, the next step in diagnosing is to remove a small sample or perform a biopsy.
- Pathologists examine the tissue under the microscope to determine the cells involved, whether it is a benign growth or a malignant one, and the type of cancer.
- Diagnosing mesothelioma as tubulopapillary involves looking at the cells to identify the characteristic tubules and papillary structures and also to determine that the cells involved are epithelial rather than sarcomatoid.
Treating Tubulopapillary Mesothelioma
Treatment for tubulopapillary mesothelioma depends on the stage of the cancer and the individual patient. Most mesothelioma cases are treated with a multi-modal approach.
Medical teams use surgery if possible to remove as much of the cancerous tissue as possible and supplement surgery with chemotherapy or radiation to kill any cells that couldn’t be removed.
The outlook for anyone with mesothelioma is generally poor. This is a difficult cancer to treat because most people are diagnosed and begin treatment after it has already spread or even metastasized.
On the other hand, tubulopapillary mesothelioma has a longer life expectancy than other types of epithelioid mesothelioma. This may be a result of the slower, less aggressive growth of the tumors.
What Is the Prognosis for Tubulopapillary Mesothelioma?
All types of malignant mesothelioma have a poor prognosis compared to most other types of cancer. However, epithelial and specifically tubulopapillary diagnoses have better outlooks than other mesothelioma types.
A study of median overall survival in epithelioid mesothelioma patients confirmed this. The overall survival time for those with a tubulopapillary diagnosis was 17.9 months, compared to 15.8 months, 13.7 months, and 8.1 months in other types.
Patients with the peritoneal form of tubulopapillary mesothelioma have an even better prognosis. Peritoneal mesothelioma life expectancies are typically longer than those for pleural patients because it is a little easier to treat.
Peritoneal patients benefit from HIPEC, a type of localized chemotherapy that follows surgery and leads to improved survival rates.
If you were exposed to asbestos in the past and have symptoms of mesothelioma, like coughing, chest pain, and shortness of breath, it is important to be screened as soon as possible. Diagnostic techniques are getting better, and new treatments are helping patients live longer and have a better quality of life. The best thing you can do is to get an accurate diagnosis now.Get Your FREE Mesothelioma Packet
Page Medically Reviewed and Edited by Pinar Kanlikilicer, PhD
Dr. Pinar Kanlikilicer has a PhD in Biomedical Engineering. She completed her 5-years of postdoctoral training in the Department of Experimental Therapeutics at MD Anderson Cancer Center. She is currently working in the field of cancer as a research scientist.