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It is very difficult to diagnose mesothelioma because of many different types of cells that can make up a mesothelioma tumour. Mesothelioma tumour cells are very similar to some types of lung cancer cells. Sometimes it can be very difficult for a pathologist to decide whether or not the cancerous cells are mesothelioma cells, lung cancer cells or even, sarcoma cells.
To help with diagnosis mesothelioma, scientists are trying to find a tumour marker for mesothelioma. A tumour marker is a chemical given off by cancer cells that can be found in the blood and picked up in a blood test. If a definite tumour marker could be discovered for mesothelioma this would be of great benefit for doctors in making more accurate diagnosis of this disease and may also be helpful to monitor the success of treatment.
In a typical case, an individual with Mesothelioma will first experience chest pain and shortness of breath. Often, there is a build-up of fluid in the lung area, known as a plueral effusion. Since many doctors may not have experience treating Mesothelioma patients, these symptoms are often mistaken for other lung problems, such as pneumonia.
Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized.
Your doctor may consider these factors when choosing a diagnostic test:
The following represents a list of diagnostic procedures that a doctor may use to determine whether a person has Mesothelioma.
Imaging tests, such as CAT Scans, x-rays and MRIs allow doctors to see a picture of the area in question.
Cytology tests involve examining the pleural fluid for cancer cells after the fluid is removed from the lung area using a needle. Fluid samples may be taken with a needle and sent to the lab to see if cancer cells are present. Medical experts consider this test to have limited value in diagnosing Mesothelioma, because negative or inconclusive readings can result from the tested fluid.
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a histopathologist. A biopsy may 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, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Thoracoscopy. A thoracoscopy, which is a relatively new technique, allows the doctor to look directly into the chest (pleural) cavity at the tumor and during the same operation to also take a tissue sample for laboratory analysis. The thoracoscopy is performed by making a small incision into the chest and using a tiny video camera to inspect the region. The doctor can then use forceps to obtain a tissue biopsy. A laparoscopy, a similar operation, is used to obtain a biopsy of a peritoneal tumor.
A thoracoscopy or a laparoscopy procedure involves looking directly at the tumor and taking a sample of tissue. The tissue sample is examined by a pathologist then examines. In these procedures, a doctor makes a small incision and uses a tiny video camera to look at the area in question.
Bronchoscopy. A bronchoscopy, which examines the airways, or a mediastinoscopy, which looks at the lymph nodes in the chest, allows the doctor to look at the area using a lighted tube. Samples may be taken with a needle and sent to the lab to find out if cancer cells are present. However, bronchoscopy and mediastinoscopy are not that effective for diagnosing mesothelioma, as the disease is seldom found within the airways or the lymph nodes. A bronchoscopy or a mediastinoscopy uses a lighted tube to let the doctor look at the affected area of lung.
Pleural biopsy. Diagnosing mesothelioma requires an adequate biopsy specimen. However, because mesothelioma usually arises from the lower part of the diaphragmatic and/or parietal pleura, obtaining enough tissue may be difficult. A simple, or closed, pleural biopsy involves the insertion of a needle into the chest cavity to obtain tissue from the pleural membrane for analysis.
This technique is minimally invasive and normally requires only local anesthesia. This technique, however, may not provide adequate material for the necessary stains of the tissue to make a diagnosis of mesothelioma. Moreover, since the biopsy is not done under direct vision, the sample may not be exactly in the area of the tumor. If the diagnosis cannot be made with this relatively noninvasive technique, an adequate tissue sample usually can be obtained via an open pleural biopsy. In this approach, a surgeon makes an incision on the patient's side and goes into the pleural space. This method allows maximum exploration of the pleural membranes as well. However, the technique requires general anesthesia.
A needle biopsy, which is done under anesthetic, involves inserting a large hollow needle through the skin and into the chest cavity. The doctor rotates the needle and as the needle is taken out, the doctor can collect tissue samples. Because of the small sample size of the tissue, experts consider this type of biopsy to be only 25 to 60 percent accurate in diagnosing Mesothelioma.
It is not easy to diagnose mesothelioma, as its' symptoms are similar to other disorders. Some patients exhibit mesothelioma symptoms whereas others may not. Delay in diagnosis could cause delay in appropriate treatment. Do not be indifferent to shortness of breath, persistent cough or chest pain as these are the symptoms of plural mesothelioma. Note that even experienced pathologists find it difficult to detect mesothelioma symptoms, resulting in the absence of proper treatment.
Peritoneal mesothelioma could cause symptoms such as swelling in the abdomen, swelling of the feet, weight loss, bowel obstruction or anemia. Plural effusion, which is an accumulation of fluid between the chest cavity and the lining of the lung, is a common symptom of mesothelioma. Increase in this fluid could result in shortness of breath. Pathologists carry out x-rays and CT scans to decide a course of treatment for effusions.
Diagnosis of mesothelioma involves review of the patient's medical history, x-rays of chest or abdomen, a complete physical examination and a thorough examination of lung functions. MRI or CT scan could also be carried out to diagnose mesothelioma. If these tests give any indication of mesothelioma, biopsy is essential to confirm this diagnosis. Tissue biopsy or fluid diagnosis is essential for definitive diagnosis of mesothelioma.
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