A biopsy is defined as “an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.” In diagnosing mesothelioma, a biopsy is considered the “gold standard” meaning it is the single most important procedure when arriving at an accurate diagnosis. Although mesothelioma can, in some cases, be diagnosed from testing fluids (pleural effusion or ascites), the biopsy is considered the most reliable diagnostic tool.
Needle biopsy
A tissue biopsy simply means that the clinician removes a part of the suspected tissue (suspected mesothelioma) for closer examination. Most biopsies are needle biopsies, meaning a needle is used to access the suspicious tissue. Sometimes a CT-guided biopsy will be used. In this case, the patient rests in a CT-scanner and the scanner’s images help doctors determine the exact position of the needle.
Pneumothorax
In some cases where possible pleural mesothelioma is being investigated, the needle can create a small hole in the lung which can cause air to fill the space between the lung and chest wall. This is called a pneumothorax and, depending on the size, could require treatment such as using a catheter to vacuum out the trapped air.
Endoscopic biopsies
Endoscopic biopsy is commonly used in mesothelioma diagnosis. An endoscope is a thin instrument that has a light and a lens (or video camera) and usually has a tool to remove tissue samples. Endoscopes have different names depending on the part of the body where they’re used.
Suspected Pleural Mesothelioma
Thoracoscope for thoracoscopy:
An endoscope called a thoracoscope is used to look at areas inside the chest and at the pleura and take tissue samples for biopsies. Thoracoscopy is generally performed in the operating room under general anesthesia. The doctor inserts the thoracoscope through one or more small incisions made in the chest. Thoracoscopy can also be used as part of a procedure to remove fluid from the chest. This is called pleurodesis.
Suspected Peritoneal Mesothelioma
Laparoscope for laparoscopy:
An endoscope called a laparoscope is used to look inside the abdomen and take a sample (biopsy) of any peritoneal tumors. This is usually done in the operating room while the patient is under general anesthesia. The laparoscope is inserted into the abdomen through small abdominal incisions.
Surgical biopsy
If a needle or endoscopic biopsy is not sufficient, doctors may recommend a more invasive surgical biopsy. Here, either open or laparoscopic surgery may be necessary to obtain hard-to-reach tissue.
Once biopsy material is obtained, it is given to a pathologist so that this doctor can use various tools and tests to identify precisely what tissue or cancer has been removed from the patient.
Related Posts
Recurring Collapsed Lung as an Early Indicator of Malignant Mesothelioma - A new article highlights the link between a collapsed lung and mesothelioma. Mesothelioma, caused by asbestos exposure, can present unexpectedly. It often requires many clinical tests for accurate diagnosis and treatment planning. A new study explores the case of a 73-year-old man whose recurrent collapsing lung was found to be mesothelioma. This shows the importance of thorough tissue examination for early detection and diagnosis. The Unusual Case The patient was a 73-year-old man who experienced recurrent collapsed lungs. This is where air collects in the pleural space around the lungs. A chest CT scan showed a left collapsed lung and calcified plaques. This finding implied prior asbestos exposure. Other symptoms, including nodules in both lungs, raised the suspicion of mesothelioma....
New Way to Identify Biopsy Sites to Diagnose Mesothelioma - A study in Cancer Diagnosis and Prognosis explores a new way to identify biopsy sites to diagnose mesothelioma. Mesothelioma is an aggressive cancer caused by asbestos exposure. There are a few different types of mesothelioma. One type is malignant peritoneal mesothelioma. It is hard to diagnose peritoneal mesothelioma because its symptoms could also be caused by other diseases. It usually requires many tests to diagnose peritoneal mesothelioma. The delay in diagnosing peritoneal mesothelioma also delays treatment. The first diagnostic test is usually computed tomography (CT). CT scans are like a more sophisticated X-ray. The results of the CT scan help doctors locate the best place to conduct a biopsy. A biopsy is the examination of tissue to discover if the...
Serum IgG4: A New Biomarker for Mesothelioma Pleural Effusion - Egyptian scientists say a new biomarker is very good at identifying mesothelioma. Pleural effusions are pockets of excess fluid. They collect around the lungs of people with certain kinds of cancer and other conditions. Biomarkers in pleural effusions are proteins and other substances found in mesothelioma patients. The new study suggests that using this biomarker the right way can lead to more accurate diagnoses. The Importance of Biomarkers in Pleural Effusions Pleural mesothelioma is a rare cancer of the lung lining. It is a challenge to diagnose. The early symptoms can be as vague as cough and fatigue. But an accurate diagnosis is often the difference between life and death. As tumors grow, mesothelioma patients produce pleural effusions or ‘water...
New Tips for Diagnosing Malignant Peritoneal Mesothelioma - Malignant peritoneal mesothelioma is an aggressive cancer that often mimics other conditions. This can make it difficult to get a definitive diagnosis. But a new report in Pathology Case Reviews provides tips for identifying peritoneal mesothelioma. Diagnosing Malignant Peritoneal Mesothelioma Mesothelioma is usually diagnosed after a person experiencing symptoms goes to a doctor. Patients often complain of vague abdominal symptoms, such as pain, nausea, bloating, weight loss. Distinguishing peritoneal mesothelioma from other cancers is important to ensure appropriate treatment. One thing a doctor may do is perform a tissue biopsy. The doctor will remove a part of the tissue (suspected mesothelioma) for examination. A biopsy is the “gold standard” and the single most important procedure for an accurate diagnosis. Doctors...
Combining Cytology and Immunology for a Less Invasive Mesothelioma Diagnosis - An invasive surgical or tissue biopsy is often required to get a definitive mesothelioma diagnosis. But a new hybrid exam might offer an alternative for mesothelioma patients. It involves the combination of cytology and immunology. Cytology tests look at the cells in body fluids. It is the analysis of a patient’s cells under a microscope. And immunology is the study of the immune system. Together, these two areas of science provide new hope for mesothelioma patients. The Tokyo Medical University in Japan has been looking into advanced diagnostic options. They believe that a combination of cytology and immunology methods can lead to a definitive diagnosis. This is good news for mesothelioma patients. It will mean a quicker mesothelioma diagnosis without...
Mesothelioma Mimics Ovarian Cancer: Lessons from a Case Report - Mesothelioma mimics ovarian cancer in a new report by Radiology Case Reports. Mesothelioma is a rare and very aggressive tumor of the peritoneum. Similar clinical and imaging presentations mean mesothelioma mimics ovarian cancer at times. Yet, a history of asbestosis exposure is key as the main risk factor for mesothelioma. Imaging plays a key role in getting the diagnosis correct. It narrows down the diagnosis possibilities. Ultrasound-guided biopsy with histological study can confirm a mesothelioma diagnosis. Case Report Misdiagnosis The Bangladesh National Institute of Oncology recently published a case report. A 42-year-old woman reported pelvic pain and progressive abdominal distension. An abdominal ultrasound revealed a high volume anechoic peritoneal effusion. Further investigation showed extensive peritoneal disease and bilateral ovarian tissue...
Diagnostic Accuracy of Lung Fluid Tests for Mesothelioma - Researchers in Germany say the diagnostic accuracy of lung fluid tests for mesothelioma is high enough that they can be routinely used for diagnosis. Right now, if mesothelioma is suspected, doctors may order a fluid test first. If the fluid test (cytology) is positive, the doctor usually orders a tissue biopsy (histology) to confirm. But the German team says their study shows that the diagnostic accuracy of cytology is almost as good as histology for mesothelioma – especially when doctors consider the patient’s hyaluronic acid level, too. Scientists from several German institutions analyzed cytology tests from more than 4,500 suspected cases of pleural mesothelioma. They conclude that cytology is accurate enough to be used routinely for diagnosis. The Importance of...
Misdiagnosis of Mesothelioma More Common with Cytology Alone - A new set of case reports illustrates how easily misdiagnosis of mesothelioma can happen when the diagnosis is based on cytology alone. Cytology tests look at the cells in body fluids. For peritoneal mesothelioma patients, this is often the fluid that collects in their abdomen called ascites. But doctors from India’s Dayanand Medical College and Hospital say using ascites samples alone to diagnose mesothelioma is a risky practice. Misdiagnosis of mesothelioma may delay proper treatment and negatively impact survival. The Difficulty of Diagnosing Peritoneal Mesothelioma Malignant mesothelioma only impacts about 2,500 people in the US every year. It is most common among people who have lived or worked around asbestos. Peritoneal mesothelioma is even rarer. About a fifth of patients...
Immunohistochemical Staining and Sarcomatoid Mesothelioma: Beyond the Lab - When it comes to understanding individual cases of sarcomatoid mesothelioma, doctors should not rely too heavily on immunohistochemical staining. That conclusion comes from mesothelioma researchers at MD Anderson Cancer Center in Texas. The researchers just released a new study focused on this rare mesothelioma subtype. A patient’s subtype has an impact on what kind of treatment could work best for them. Sarcomatoid mesothelioma is usually less responsive to chemotherapy. Immunohistochemical staining is a pathology technique. It is the main way that doctors tell the difference between mesothelioma subtypes. But the MD Anderson report suggests that not all cases of sarcomatoid mesothelioma are created equal. The researchers say it is important to look beyond the lab findings to understand individual cases.... Mesothelioma Subtypes Often Misclassified by Biopsy - Pleural biopsy is not perfect when it comes to telling the difference between the three mesothelioma subtypes. But misclassification could lead to shorter survival. That is the conclusion reached by top mesothelioma researchers in Brescia, Italy. They compared autopsy records from 134 Italian mesothelioma patients. The patients were either shipyard workers or their spouses. The researchers found that the mesothelioma subtypes identified from biopsy tissue were incorrect a large percent of the time. Misclassification matters because it impacts which mesothelioma treatments doctors choose. The Three Mesothelioma Subtypes Pleural mesothelioma is an aggressive malignancy on the lung lining. It is caused by exposure to asbestos. Mesothelioma cells fall into three mesothelioma subtypes based on certain cellular characteristics. Pleural mesothelioma is notoriously...