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Mesothelioma Diagnosis

How is mesothelioma diagnosed?

Once you go to your physician for a consultation and/or a checkup, there will be several things that he/she will do:

Medical history – a complete and comprehensive medical history should be taken. This will be to assess risk factors, genetics, habits and sort through your symptoms.

Physical examinations - this will provide the physician a chance to assess your symptoms, general health and if you’ve had exposure to asbestos, he will check for:

  • Fluid in the chest cavity (signs of pleural mesothelioma),
  • Fluid in the abdomen (signs of peritoneal mesothelioma),
  • Fluid in the pericardium (signs of pericardium mesothelioma).

Depending on these results, the physician may order:

1. Imaging tests – these can include x-rays, CAT scans, and MRI scans.

2. CT scan – uses a rotating x-ray beam to create a series of pictures of the body from many angles.

3. MRI scan – uses magnetic fields instead of x-rays to create images of selected areas of the body.

Tests of fluids and tissues samples can be obtained via biopsies (removing a sample of tissues) and these other various methods:

  • A needle into the chest, or abdomen, or pericardium to remove a sample of fluid.
  • Thoracoscopy, which is an instrument connected to a micro-camera and can be inserted incision to collect fluid or tissue samples.
  • Laparoscopy, a flexible tube attached to a video camera, can be used to obtain a sample of tumors in the abdominal cavity.
  • Surgery – either a thoracotomy (opens the chest) or laparotomy (opens the abdominal cavity allows the surgeon to remove a tissue sample of the tumors.
  • Bronchoscopy – a flexible tube is inserted down the trachea and into the bronchi to check for masses in the airway. Tissue samples can be removed. This is used for patients with pleural mesothelioma.
  • Mediastinoscopy – a lit tube is inserted at the neckline and down under the sternum at the neck and moved down into the chest. This procedure allows the surgeon to look at the lymph nodes and remove tissue samples. A check of the lymph nodes allows a doctor to see if the mesothelioma is still localized or if its spread.

Diagnosing mesothelioma is particularly difficult to diagnose, as it resembles other types of cancers in the beginning. For example: pleural mesothelioma can look like several other types of can resemble other lung cancers and peritoneal mesothelioma may resemble some ovarian cancers. Because of this, correct diagnosis requires the use of specialized lab tests to recognize certain markers (types of chemicals) known to contained mesotheliomas. The electron microscope can sometimes help in this diagnosis as it can magnify samples 100 times greater than the light microscope, which is normally used in cancer diagnosis.

At this point in time, the best diagnostic tool is the open pleural biopsy performed during thorascocopy.

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