Mesothelioma Cell Types

There are three mesothelioma cell types: epithelioid, sarcomatoid, and biphasic. Your cell type greatly affects your prognosis (health outlook) and treatment options. Get help finding the best doctors and treatments for any mesothelioma cell type.

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Written and Fact-Checked by: Lung Cancer Group

Last updated: May 29, 2025

Top Topics:

Epithelioid Mesothelioma
Sarcomatoid Mesothelioma
Biphasic Mesothelioma
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What Are the 3 Types of Mesothelioma Cells?

There are three major histological (cell) types of mesothelioma, depending on which cells are found in the tumor.

Malignant mesothelioma histological types include:

Epithelioid mesothelioma: This is the most common type and the easiest to treat. It accounts for about 70% of cases, according to the UPMC Hillman Cancer Center.
Sarcomatoid mesothelioma: This is the rarest type and responds poorly to treatment. It makes up 10% to 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. About 20% to 30% of cases fall under this type, according to the ACS.

Oncology (cancer) doctors can determine your cell type when making a diagnosis using a biopsy, where a tissue sample is reviewed under a microscope. They can then suggest treatments based on the cell type, your overall health, and other factors.

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

How Doctors Determine the Histology of Mesothelioma

Histology is the study of cells and is crucial to determining mesothelioma cell type.

Steps to determine malignant mesothelioma histology include:

Biopsy removal: Doctors take a sample from the tumor or fluid that is suspected to be cancerous.
Mesothelioma pathology review: The biopsy sample is sent to a pathologist, a 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 mesothelioma specialist will review them and explore potential treatments.
Second opinion: If you want to be certain that you received an accurate mesothelioma diagnosis, request a second opinion. You may have another biopsy sample reviewed or have your original one examined by a different pathologist.

Mesothelioma is very rare, so it’s important to have a pathologist who specializes in this cancer carefully review a biopsy sample for accuracy. A second opinion can also help prevent misdiagnosis.

“I think that’s really, really critical, having somebody who has seen the disease before reviewing any kind of pathology.”

— Dr. Deepa Magge, mesothelioma specialist

Epithelioid Mesothelioma Cells

Malignant epithelioid mesothelioma can develop when healthy epithelial cells that line the body’s surfaces and cavities are exposed to asbestos. It’s also called epithelial mesothelioma.

Epithelial mesothelioma cells are shaped like cubes or ovals. They divide rapidly but stick together, meaning they spread more slowly and are easier to treat than other mesothelioma cell types.

Epithelioid Mesothelioma Prognosis

Epithelioid malignant mesothelioma typically has the best prognosis of any mesothelioma cell type.

Mesothelioma prognosis is measured by:

Life expectancy: The median epithelioid mesothelioma life expectancy is 14 months with treatment.
Survival rate: The 2-year epithelial mesothelioma survival rate is 45% and the 5-year survival rate is 14% when when treated with surgery, according to 2022 data from the National Cancer Database (NCDB).

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

Epithelioid Mesothelioma Treatment Options

Epithelioid mesothelioma patients may have more treatment options available compared to patients with the other cell types.

Commonly used epithelial mesothelioma treatments include:

Chemotherapy: These are cancer-killing drugs. Epithelioid patients lived for nearly 27 months on average when chemotherapy was the first treatment used in a 2021 study.
Immunotherapy: Medicine that improves the body’s response to cancer. A recent trial found that epithelial patients lived for 18.7 months when treated with immunotherapy.
Radiation: X-rays and other beams of energy shrink tumors. Radiation allows patients with epithelial mesothelioma to live for nearly 29 months, according to a recent NCDB data analysis.
Surgery: Doctors can remove mesothelioma tumors with different surgeries. Epithelioid patients live for over 22 months on average with surgery, as noted in the NCDB data report.

Doctors can determine which treatments will work best for your epithelial mesothelioma by assessing your overall health, cancer location, stage, and more.

Sarcomatoid Mesothelioma

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

Metastasis (cancer spread to other parts of the body) is also more likely since the cells don’t stick together as easily, according to Moffitt Cancer Center.

Sarcomatoid Mesothelioma Prognosis

Since sarcomatoid mesothelioma cells can spread quickly, this type has the worst prognosis.

Here are some sarcomatoid mesothelioma survival statistics:

Life expectancy: The average sarcomatoid mesothelioma life expectancy is 4-7 months.
Survival rate: The 2-year sarcomatoid mesothelioma survival rate is 15% and the 5-year survival rate is 4% when treated with surgery, according to a 2023 study.

Even though sarcomatoid patients often have a poor prognosis, some may still become long-term survivors with help from top doctors.

Sarcomatoid Mesothelioma Treatment Options

Doctors can use a variety of treatments for sarcomatoid mesothelioma, particularly if the cancer is caught in an early stage.

These include:

Chemotherapy: Sarcomatoid patients had a life expectancy of nearly 11 months in a 2021 Scientific Reports study.
Immunotherapy: This treatment can help patients with sarcomatoid mesothelioma live for over 15 months as noted by an analysis of NCDB data.
Radiation: When treated with radiation, sarcomatoid patients had an average life expectancy of 18.3 months, according to NCDB figures.
Surgery: Sarcomatoid mesothelioma is rarely treated with surgery due to its aggressive nature, according to Moffitt Cancer Center. However, early-stage sarcomatoid patients lived for nearly 8 months with surgery in a recent report.

Speak to a nurse to find top health care specialists and treatments for all mesothelioma cell types.

Biphasic Mesothelioma

Biphasic tumors consist of both epithelioid and sarcomatoid mesothelioma cells. If a biphasic mesothelioma tumor has more epithelial cells, it’s easier to treat.

Doctors must use great care when analysing a biopsy sample as biphasic mesothelioma can be misdiagnosed if one of the other cell types is predominant.

“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

Malignant biphasic mesothelioma has a worse prognosis than epithelial mesothelioma but a better one than sarcomatoid.

Biphasic prognosis includes:

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 NCDB data.

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.

Biphasic Mesothelioma Treatment Options

Biphasic mesothelioma responds better to treatments if more epithelial cells are present than sarcomatoid ones.

Common treatments for biphasic mesothelioma include:

Chemotherapy: Biphasic mesothelioma patients have an average life expectancy of 11 months when chemotherapy is used, according to data from the NCDB.
Immunotherapy: The NCDB data review shows that biphasic mesothelioma patients typically live for 9 months when treated with immunotherapy.
Radiation: This treatment allows biphasic mesothelioma patients to live for an average of 9.3 months.
Surgery: If doctors can remove all visible cancer tumors, patients with biphasic mesothelioma live for 12.4 months on average.

Specialized mesothelioma doctors can give you a better idea of which treatments may be used in your case.

Rare Mesothelioma Cell Types

In some instances, 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 or pleura. These mesothelial cells have lace-like patterns when viewed under a microscope.
Cystic: his type usually develops in cases of epithelioid peritoneal mesothelioma (which forms in the peritoneum or 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% to 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 it as 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 is often benign.

If you suspect you may have mesothelioma, see a specialist who treats this cancer. Top doctors can recommend the best treatments for your case, even if you have a rare mesothelioma cell type.

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

Get Help for Any Mesothelioma Cell Type

Each mesothelioma cell type can significantly impact your overall health outlook, so getting an accurate and early diagnosis is crucial to living as long as possible.

If you’re facing mesothelioma, our skilled registered nurses and patient advocates are ready to help you take charge of your health.

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 our mesothelioma nurses now to get started.

Mesothelioma Histology & Cell Types FAQs

What are the different types of mesothelioma cells?

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, are very hard to treat, and are the rarest type.

Biphasic mesothelioma tumors contain both of the other types. If more epithelial cells are present, they may be more responsive to treatments.

What’s the difference between epithelioid vs. sarcomatoid mesothelioma?

Epithelioid mesothelioma cells are shaped like ovals or cubes and stick together, meaning they spread more slowly through the body. As a result, epithelioid mesothelioma responds better to treatment.

Spindle-shaped sarcomatoid cells don’t collect together and can break off to form new tumors in different parts of the body, making it harder to treat.

Epithelioid mesothelioma is much more common, with about 70% of all patients having this type. Sarcomatoid mesothelioma is the rarest type. Only about 10% to 20% of mesothelioma patients have it.

What is the cell of origin of mesothelioma?

Mesothelioma develops when healthy cells in the body mutate as a result of asbestos exposure. If you breathe in or swallow asbestos dust, microscopic fibers can get trapped in the lining of your body.

These fibers can irritate healthy cells and tissues and cause mutations after 10-50 years, turning normal cells into malignant ones.

Does mesothelioma have spindle cells?

Yes, but only in some cases. One specific cell type known as sarcomatoid mesothelioma has spindle-shaped cells.

These cells are less likely to stick together and can more easily spread through the body, making sarcomatoid mesothelioma harder to treat.

Call (877) 446-5767 for help finding doctors who can determine your mesothelioma cell type and recommend the best treatments for your case.

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. However, they do know that only asbestos exposure causes mesothelioma.

Why do mesothelioma cell types matter?

The cell type of malignant mesothelioma matters since each affects a patient’s prognosis in different ways.

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