Mesothelioma Diagnosis

The diagnosis of mesothelioma can oftentimes be difficult, because symptoms of both pleural and peritoneal mesothelioma mimic those of more common conditions. Pleural mesothelioma can be mistaken for persistent pneumonia, or early stages of peritoneal mesothelioma might be attributed to other bowel disorders. One of the most important tools in the first stages of diagnosing mesothelioma is a thorough review of patient history to check for exposure to asbestos.

If a doctor suspects mesothelioma of the lungs, one of the first steps towards diagnosis would be obtaining a chest x-ray. While an x-ray normally cannot show mesothelioma, it can show pleural effusions (fluid between the lungs and chest wall) that are sometimes associated with the disease. An MRI or a CAT scan may also be obtained, and these are useful in estimating lung size and locating or determining the existence of cancerous growths or tumors.

Once pleural mesothelioma is strongly suspected, the next step for final diagnosis would be a thoracoscopy. This is a surgical procedure and usually requires a hospital stay and anesthesia to perform. The doctor will make a small incision in the chest wall and insert an instrument called a thoracoscope. With this instrument, a doctor can look at the lungs. A thoracentesis, which drains fluid collections of pleural effusion, may also be performed. The fluid collections will then be sent to pathology for diagnosis. During thoracoscopy, if the doctor finds evidence of abnormal tissue, a biopsy of the area will be taken and sent to pathology, as well. Once this tissue is examined by a pathologist for cancerous cells, a definitive diagnosis of mesothelioma can be made.

If a physician has a strong suspicion for abdominal mesothelioma, usually a peritoneoscopy will be carried out. This surgical procedure involves the insertion of a peritoneoscope through the wall of the abdomen, and is usually carried out in the hospital under anesthesia. Much like the diagnosis of pleural mesothelioma, if the physician finds areas suspicious for malignancy, a biopsy of that area will be taken and sent to pathology for positive diagnosis.

Once diagnosis by biopsy is obtained of either peritoneal or pleural mesothelioma, the next step taken would be determining the stage (or severity) of the disease. More specialized tests are needed to determine the staging, but this is a very important step, as treatment depends on the extent to which the disease has spread. Localized mesothelioma, the first stage, is considered to be present when the cancer is only found in one area of the body, where the disease originated. Advanced mesothelioma is a metastatic cancer, which means that it has spread to other areas of the body from where it began, usually first to lymph nodes, lungs, abdominal organs, or the chest wall.

While the diagnosis of mesothelioma may still be difficult, partly due to its rarity as a disease and partly due to its nonspecific symptoms, once it is recognized there are several treatment options available. Choosing a physician who is knowledgeable in this area is the first step to receiving the right treatment at the right time.

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