Diagnosis

Diagnosing mesothelioma often difficult, because symptoms similar those number other conditions. Diagnosis begins review patient's medical history. A history exposure asbestos y increase clinical suspicion mesothelioma. A physical examination performed, followed y chest X-y often g function tests. T O A Oy X-y y reveal pleural thickening commonly after asbestos exposure increases suspicion mesothelioma. A CT ( CAT) MRI usually performed. I large amount fluid present, abnormal cells y detected y cytopathology fluid aspirated syringe. F pleural fluid, y thoracentesis thoracostomy (chest ); ascites, paracentesis ascitic drain; pericardial effusion pericardiocentesis. While absence malignant cells cytology completely exclude mesothelioma, makes unlikely, especially alternative diagnosis (.g. tuberculosis, heart failure). Unfortunately, diagnosis malignant mesothelioma y cytology alone difficult, expert pathologists.

Generally, biopsy needed confirm diagnosis malignant mesothelioma. A doctor removes sample tissue examination under microscope y pathologist. A biopsy y different ways, depending where abnormal found. I cancer chest, doctor y perform thoracoscopy. I procedure, doctor makes small through chest p thin, lighted called thoracoscope chest between . Thoracoscopy allows doctor inside chest obtain tissue samples. Alternatively, chest surgeon might directly p chest (thoracotomy). I cancer abdomen, doctor y perform laparoscopy. T obtain tissue examination, doctor makes small incision abdomen inserts special instrument abdominal cavity. I these procedures yield enough tissue, extensive diagnostic surgery y necessary.

Immunohistochemical studies py important pathologist differentiating malignant mesothelioma neoplastic mimics. There numerous tests panels available. N single perfect distinguishing mesothelioma carcinoma benign versus malignant.

There three histological types malignant mesothelioma: (1) Epithelioid; (2) Sarcomatoid; (3) Biphasic (Mixed). Epithelioid comprises about 50-60% malignant mesothelioma cases generally holds better prognosis Sarcomatoid Biphasic subtypes.

Staging

Staging mesothelioma based recommendation y International Mesothelioma Interest Group. TNM classification primary tumor, lymph involvement, distant metastasis performed. Mesothelioma staged Ia–IV (-A ) based TNM status.