Struggles of Diagnosing Sarcomatoid Mesothelioma

Struggles of Diagnosing Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma and sarcomatoid carcinoma can be hard to tell apart during diagnosis. A study published in Diagnostics reveals that a new panel test could help to distinguish between these two diseases.

Mesothelioma is caused by asbestos. There are three different types of mesothelioma: epithelioid, sarcomatoid, and biphasic.

Patients who are diagnosed with sarcomatoid mesothelioma face a much poorer outlook than those with the more common epithelioid form of the disease.

Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma is also the least common form of this already rare cancer. Sarcomatoid mesothelioma includes only about 10 percent of the 2,000 to 3,000 mesothelioma cases diagnosed in the United States each year.

Out of the three different types of mesothelioma, the sarcomatoid type is the most aggressive. Studies find that patients with sarcomatoid mesothelioma survive for an average of five to six months.

This is why an early diagnosis of mesothelioma is so important. If doctors could find a way to diagnose mesothelioma earlier, it could improve the odds of surviving it.

One way to diagnose mesothelioma is by testing the cells in a tissue sample, or biopsy. The biopsy is considered the most reliable diagnostic tool.

New Panel Test

Researchers in Italy tested the accuracy of a “two-hit” panel test to diagnose either sarcomatoid mesothelioma or sarcomatoid carcinoma.

The panel test measures Claudin-4 and BAP1. Claudin-4 is a biomarker produced by sarcomatoid carcinoma. BAP1 is a biomarker that is limited by sarcomatoid mesothelioma.

This panel was already successful in differentiating between epithelioid mesothelioma and conventional carcinoma. It had a 96% rate of diagnostic accuracy with these two cancers.

To test the panel against sarcomatoid mesothelioma and sarcomatoid carcinoma, the researchers looked at biopsy samples from past patients.

The researchers found that this this “two-hit” panel test was effective at differentiating between these two cancers. An additional biomarker panel may be needed for confirmation.


Zuccatosta L, Bizzarro T, Rossi G, Gallo G, Gasparini S, Ambrosini-Spaltro A. Immunohistochemistry for Claudin-4 and BAP1 in the Differential Diagnosis between Sarcomatoid Carcinoma and Sarcomatoid Mesothelioma. Diagnostics (Basel). 2023;13(2):249. Published 2023 Jan 9. doi:10.3390/diagnostics13020249. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9858564/

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