Mesothelioma - Diagnosis
Because mesothelioma symptoms are similar to those of a number of other conditions, the mesothelioma diagnosis is often challenging. A review of the patient’s medical history marks the start of the mesothelioma diagnosis. Clinical suspicion for mesothelioma is increased if the individuala have a history of asbestos exposure. What follows is a physical examination, then a chest X-ray and frequently lung function tests. They are frequently observed after asbestos exposure and the X-ray may indicate pleural thickening. Thus, suspicion of mesothelioma is increased. A CT (or CAT)scan or an MRI is normally conducted. If a large amount of fluid is present, cytology can detect the abnormal cells if the fluid is aspirated with a syringe. For pleural fluid, this is conducted by a pleural tap or chest drain. Also in ascites, it is carried out with an paracentesis or ascitic drain. In a pericardial effusion, this is done with pericardiocentesis. The non-existence of malignant cells on cytology does not exclude mesothelioma; it makes it very unlikely, especially if another diagnosis can be conducted ( for example: heart failure, tuberculosis)
A biopsy is required to confirm a mesothelioma diagnosis if cytology is positive or a plaque is regarded as suspicious. A physician removes a tissue sample for a microscopic examination by a pathologist. A biopsy may be carried out in various ways, depending on where the abnormal area is identified. If the cancer is discovered in the chest, the physician may perform a thoracoscopy. For this method, the physician makes a minor cut through the chest wall and inserts a thin lit tube called a thoracoscope into the chest between two ribs. Thoracoscopy permits the physician to view inside the chest and get tissue samples.
The physician may conduct a laparoscopy if the cancer is discovered in the abdomen. Then the physician makes a minor opening in the abdomen and puts a special instrument into the abdominal cavity to get tissue for examination. If these methods fail to provide sufficient tissue, additional extensive diagnostic surgery may be required.
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