Mesothelioma Diagnosis-Diagnosing mesothelioma is often difficult, because the symptoms are similar to several other conditions. Diagnosis begins with a review of patient medical history. History of exposure to asbestos may increase clinical suspicion for mesothelioma. Physical examination performed, followed by chest X-ray and often lung function tests. X-ray can reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. CT (or CAT) scan or MRI is usually performed.
If a large amount of fluid is present, abnormal cells can be detected by Cytopathology if the fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While the absence of malignant cells on cytology does not completely exclude mesothelioma, it makes far more likely, especially if an alternative diagnosis can be made (eg tuberculosis, heart failure).
If cytology is positive or plaques that are considered suspicious, a biopsy is needed to confirm the diagnosis of mesothelioma. A doctor remove a sample of tissue for examination under a microscope by a pathologist. A biopsy can be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, doctors make a small cut through the chest wall and puts a thin, tube called a thoracoscope into the chest of light between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserting a special instrument into the abdominal cavity. If this procedure does not yield enough tissue, more extensive diagnostic surgery may be required.
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