Diagnosis of Mesothelioma

There are several imaging techniques which may prove useful when mesothelioma is suspected due to the presence of pleural effusion combined with a history of occupational or secondary asbestos exposure. While these imaging techniques can be valuable in assessing the possibility of the cancer, definitive diagnosis is still most often established through fluid diagnosis or tissue biopsy. Specifically diagnosing for Mesothelioma :

A. Physical Examination.
A doctor begins the mesothelioma diagnosis by doing a complete physical exam and reviewing your medical history.

B. Some of the most commonly used imaging methods include:

1. X-ray. X-rays may show abnormalities if you have pleural mesothelioma.
2. Abdominal CT scan. Computerized tomography (CT) may reveal abnormalities in your chest or abdomen if you have mesothelioma.
3. Magnetic Resonance Imaging (MRI). Better able to identify tumors as opposed to normal structures. They are also more accurate than CT scans in assessing enlargement of the mediastinal lymph nodes ( those lymph nodes which lie between the two lung), as well as a clear diaphragmatic surface, both of which play an important role in surgical candidacy.
4. Positron Emmision Tomography (PET). An important part of the diagnosis and evaluation of mesothelioma. While PET scans are more expensive than other types of imaging, and are not always covered under insurance, they are now considered to be the most diagnostic of tumor sites, as well as the most superior in determining the staging of mesothelioma.
5. CT/PET. CT/PET imaging provides a relatively new tool in this respect, and has become the imaging technique of choice for determining surgical eligibility. By combining the benefits of CT and PET (anatomic and metabolic information) into a single scan, this technology can more accurately determine the stage of the cancer.

C. Biopsy to Diagnose Mesothelioma.
Once mesothelioma is suspected through imaging tests, it is confirmed by pathological examination. If further examination is warranted, the following tests may be done:

1. Video-Assisted Thoracoscopic Surgery (VATS). The surgeon with inserts a small camera, via a scope, into one incision, and other surgical instruments used to retrieve tissue samples into the other incisions. By looking at a video screen showing the camera images, the surgeon is able to complete whatever procedures are necessary
2. Thoracoscopy. For pleural mesothelioma, the doctor may look inside the ches cavity with a special instrument called a thoracoscope. If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis
3. Peritoneoscopy. For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
4. Biopsy. If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.
5. Laparoscopy. Laparoscopy allows the surgeon to see inside your abdomen. Using one or more incisions into your abdomen, the surgeon inserts a tiny camera and special surgical tools to obtain a small piece of tissue for examination.
6. Thoracotomy. Thoracotomy is surgery to open your chest to allow a surgeon to check for signs of disease. He or she removes a sample of tissue for testing.
7. Bronchoscopy. A bronchoscopy involves inserting a flexible lighted tube through the mouth into the bronchi to remove tissue in the airway. This procedure is used for diagnosing pleural mesothelioma.