Although not studied in mesothelioma, two separate origins of cancer-associated fibroblasts and fibrocytes have been described: α-SMA expressing fibroblasts are tissue-derived, but fibrocytes with spindle-shaped nuclei are derived from macrophages or dendritic cells (α-SMA-, HLA-DR+ with moderate expression of CD68) (Figure 1) (34). This evidence concerns the gene ACTA1 and cancer.