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Mesothelioma and Sarcoidosis
The symptoms of mesothelioma and especially malignant pleural mesothelioma can sometimes be mistaken for the rare condition known as sarcoidosis.
Mesothelioma is a rare form of cancer that grows from the mesothelial tissues that line certain major organs[1]. The vast majority of mesothelioma cancers originate along the pleural mesothelial cells, which help protect and lubricate the lungs[2]. Peritoneal mesothelioma, which affects the stomach and viscera lining known as the peritoneum, makes up a much smaller portion of cases. Pericardial mesothelioma, which affects the heart’s pericardium, is extremely rare, making up just 1% of known mesothelioma cases[3].
Common symptoms of pleural mesothelioma include having trouble breathing, feeling chest pain, having a dry cough, unexplained weight loss, loss of appetite, and the sensation of strange lumps or pain in the abdomen[4].
Pleural mesothelioma commonly causes fluid to build up in the space between the pleura and the lungs, a condition known as a “pleural effusion.” These pleural effusions can be the first sign of cancer, and they serve as the symptom that prompts a pleural mesothelioma diagnosis in 90% of cases[5].
Sarcoidosis mimics many of these symptoms almost exactly, including the likelihood of pleural effusions. Common symptoms of sarcoidosis include shortness of breath, an unproductive cough, chest pain, a feeling of congestion, and wheezing[6]. Approximately 2.8% of sarcoidosis patients will develop a pleural effusion[7].
Unlike mesothelioma, sarcoidosis is not a cancer. It is a condition where cells in the body called granulomas become inflamed[8]. The condition can occur on the skin and nearly any other major organ, but it most often affects the lungs.
There is no known cure for sarcoidosis, but patients typically respond well to treatment[9]. Many cases of sarcoidosis resolve on their own. However, some cases of sarcoidosis can cause permanent organ damage, especially if not diagnosed early.
No one knows exactly how or why certain people develop sarcoidosis, although environmental factors are suspected. A study of occupational exposures that could cause sarcoidosis concluded that environments that can foster the growth of mold or other microbes may be a possible trigger[10].
Asbestos is not a known environmental cause for sarcoidosis, but it is a major factor in most mesothelioma cases[11].
Because both mesothelioma and sarcoidosis are hard to detect and present generalized chest and respiratory symptoms, the two conditions can be mistaken for one another. One report notes a case of systemic sarcoidosis that mimicked the symptoms and metastatic spread of cancer[12].
Those who have a history of work-related exposure to asbestos, mold, or other environmental contaminants and who have lung-related symptoms like breathing difficulty should request a thorough diagnosis. Their diagnosis should consider the possibility of both sarcoidosis and mesothelioma and attempt to rule out one or the other so that appropriate treatment can begin.
[1] https://www.mayoclinic.org/diseases-conditions/mesothelioma/symptoms-causes/syc-20375022
[2] https://www.cancer.net/cancer-types/mesothelioma/introduction
[3] http://www.onlinejacc.org/content/71/11_Supplement/A2374
[4] https://medlineplus.gov/mesothelioma.html
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5824618/
[6] https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/sarcoidosis/sarcoidosis-symptoms-causes-risks.html
[7] https://www.ncbi.nlm.nih.gov/pubmed/16778281
[8] https://medlineplus.gov/sarcoidosis.html
[9] https://www.mayoclinic.org/diseases-conditions/sarcoidosis/symptoms-causes/syc-20350358
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196683/
[11] https://www.cancer.org/cancer/malignant-mesothelioma/causes-risks-prevention/what-causes.html
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653310/
