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The only way to accurately diagnose mesothelioma is through a biopsy

By Treven Pyles

Posted on October 11th, 2019

Mesothelioma is a very aggressive form of cancer that affects the lining (or mesothelium) surrounding the lungs, abdomen, and heart. The sole cause of this deadly cancer type is exposure to airborne asbestos fibers and can take anywhere between 20 to 50 years to develop.

Testing for mesothelioma is usually done through a combination of X-rays and CT-PET scans. The X-ray is used to establish that a body with a different density than the surrounding tissue is present, and the CT scan provides more accurate data about its form and location.

The only way to definitively confirm a mesothelioma diagnosis is through a biopsy, a process by which a small quantity of tissue is removed from the human body to be analyzed under a microscope. In the case of mesothelioma, this can be done in five different ways.

Different types of biopsies used to diagnose mesothelioma

  • For a thoracoscopy, the surgeon inserts a small probe with a camera in the area between the ribs. This is used to optically examine the cavity and suction out fluid for analysis. The procedure is always performed under general anesthesia.
  • A mediastinoscopy also requires general anesthesia and it's employed to investigate the lymph nodes surrounding the windpipe at the base of the neck. A similar probe is used and samples of lymph and nod tissue are collected.
  • Thoracentesis is used to diagnose the cause of pleural effusions. For this, a small needle is inserted between the ribs of the back to gather a sample from the fluid build-up around the lungs. The procedure only requires local anesthetic and the surgeon uses an ultrasound machine to reach the right area.
  • Fine-needle aspiration is the medical procedure that most of us imagine when thinking of a biopsy. The said needle is used to remove a tiny part of the tumor, with the patient under local anesthetic and placed in a CT scan machine.
  • The endobronchial ultrasound-guided biopsy is the most complicated procedure of the five and consists of a camera probe being driven through the windpipe all the way to the lymph nodes in the lungs, from which a tissue sample is harvested.

The type of cells collected will help doctors narrow down the exact form of mesothelioma the patient might be suffering from, while further imaging scans will inform them about the progression of the disease. Blood tests are usually used to measure the patient's general state of health and his or her response to treatment.