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.
Visualizing the Immune Profile of Mesothelioma Patients-Researchers at MD Anderson Cancer Center in Houston have come up with a better way to analyze the immune profile of people with malignant mesothelioma. A person’s immune profile is the unique set of immune system cells and how they are working at any given time. The functionality of immune system cells in the area right around the tumor – the tumor microenvironment or TME – is especially telling. The system developed at MD Anderson assigns different colors to key immune system markers. They applied the color system to a sample from the microenvironment of mesothelioma tumors. The result was an image of each tmor’s immune profile. These images could help doctors determine new targets for mesothelioma treatment. What is … Continue reading Visualizing the Immune Profile of Mesothelioma Patients»
Medical Thoracoscopy Safe and Effective for Mesothelioma Diagnosis-UK researchers say a minimally invasive procedure called medical thoracoscopy is safe and effective for diagnosing mesothelioma and treating its symptoms. The word comes from a large medical center in Northumberland. The UK has one of the highest rates of pleural mesothelioma in the world. Rates of pleural mesothelioma in Northumberland are especially high. Mesothelioma diagnosis usually requires a biopsy. The new study finds that medical thoracoscopy enabled “high diagnostic sensitivity” with few serious complications. Understanding Medical Thoracoscopy Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating diseases affecting the pleura. The pleura is a membrane that surrounds the lung. People with mesothelioma and some other diseases can develop fluid between the pleura and the lungs. The fluid is … Continue reading Medical Thoracoscopy Safe and Effective for Mesothelioma Diagnosis»
WHO to Recognize Fourth Mesothelioma Subtype-The World Health Organization will soon recognize mesothelioma in situ as a fourth mesothelioma subtype. The 2015 WHO classification of pleural mesothelioma includes three histological subtypes. Pathologists can tell the difference between the subtypes by looking at the cells under a microscope. Each subtype has a slightly different cell shape, growth pattern, and nuclear characteristics. The proposed fourth mesothelioma subtype is a very early form of mesothelioma. Previous studies suggest that it may be a precursor to invasive mesothelioma. If patients know they have it, they may have years to try to keep mesothelioma from developing. Differences Between the Subtypes Pleural mesothelioma is a very rare type of cancer. Only about 2,500 people in the US receive a mesothelioma diagnosis … Continue reading WHO to Recognize Fourth Mesothelioma Subtype»
Mesothelioma Biopsies: Ultrasound Guidance Beats CT-A new study concludes that ultrasound guided mesothelioma biopsies are safer and just as effective as CT guided biopsies. Italian researchers analyzed both types of guidance systems for collecting tissue samples from mesothelioma patients. They compared the diagnostic yield and safety of each method. It turns out that ionizing radiation is not necessary for successful mesothelioma biopsies. As long as the technician is experienced, ultrasound guidance may be the better choice. The Importance of Mesothelioma Biopsies Pleural mesothelioma is a rare but highly aggressive kind of cancer. It grows on the membrane that surrounds the lungs. By the time patients experience symptoms of mesothelioma, the disease is often very advanced. Malignant mesothelioma can be tricky to diagnose. Mesothelioma biopsies are … Continue reading Mesothelioma Biopsies: Ultrasound Guidance Beats CT»
Mesothelioma and Metastatic Cancer: New Test Can Reliably Tell the Difference-Italian scientists have come up with what they believe is a nearly foolproof way to tell the difference between mesothelioma and metastatic cancer. Malignant mesothelioma is a membrane cancer caused by asbestos exposure. Metastatic cancer can start anywhere in the body. It can cause tumors on the pleural membrane that may be mistaken for mesothelioma. It is important for doctors to distinguish between these two types of malignancies. Mesothelioma and metastatic cancer are often treated differently. The Italian researchers say two biomarkers may make it easier to know which is which. The Difference Between Mesothelioma and Metastatic Cancer Metastatic cancer or metastatic carcinoma is cancer that has spread to another part of the body from where it started. This usually … Continue reading Mesothelioma and Metastatic Cancer: New Test Can Reliably Tell the Difference»
Liquid Biopsy for Early Stage Mesothelioma Diagnosis-Canadian researchers are exploring a liquid biopsy test that could lead to early diagnosis of malignant mesothelioma. The test is based on mesothelial precursor cells (MPC). The researchers say these cells – in combination with mesothelin and some kinds of stem cells – “could be implicated” in the development of mesothelioma. A liquid biopsy detects cells in blood instead of tissue. The University of Toronto scientists think MPC in blood may be a new mesothelioma biomarker. If it proves to be true, this kind of biopsy might be able to identify mesothelioma patients even before they have symptoms. How Liquid Biopsy Works Patients with suspected mesothelioma may have many tests. Imaging scans and blood tests can help tell if a … Continue reading Liquid Biopsy for Early Stage Mesothelioma Diagnosis»
Recurrent Pleural Effusion Could Signal High Mesothelioma Risk-The case of a Japanese woman with recurrent pleural effusion suggests the problem could be a precursor of malignant pleural mesothelioma. Pleural effusion is a build-up of fluid on the space between the layers of the membrane that surrounds the lungs. It is common with mesothelioma and some other cancers. In the new case study, the patient had recurrent pleural effusion for 15 years before she developed mesothelioma in situ. This is the earliest stage of asbestos cancer, before it becomes invasive. Her doctors say patients with similar problems should be tested for BAP1 loss and other signs of mesothelioma in situ. Understanding Recurrent Pleural Effusion Pleural effusion is a side effect of several conditions including heart disease and cancer. … Continue reading Recurrent Pleural Effusion Could Signal High Mesothelioma Risk»
Managing Mesothelioma During the COVID-19 Pandemic: New Guidelines-New guidance suggests that patients should continue to receive treatment for malignant mesothelioma during the COVID-19 pandemic. Two new reports include recommendations for hospitals to keep vulnerable patients safe. COVID-19 is especially dangerous for people with lung-related cancers like pleural mesothelioma. Their immune systems are not as strong as healthy people and their lungs are already damaged. But two new reports suggests that it may be even riskier to put off treatment for lung cancers like mesothelioma during the COVID-19 pandemic. How the Virus Could Impact Lung Cancer Patients Both of the new reports come from researchers in Pennsylvania. They focus on people with lung cancer rather than mesothelioma. But pleural mesothelioma is also a lung-related cancer. It carries many … Continue reading Managing Mesothelioma During the COVID-19 Pandemic: New Guidelines»
Breast Cancer and Mesothelioma: Case Study Illustrates Diagnostic Challenge-A newly published Croatian case illustrates how challenging it can sometimes be to distinguish between breast cancer and mesothelioma. The case involves a 61-year-old woman with what appeared to be breast cancer. Further study revealed that what the woman actually had was pleural mesothelioma. The mesothelioma had spread to her breast. Breast cancer and mesothelioma cells look similar under the microscope. But they are very different. The authors of the new report caution doctors against the “pitfall” of mistaking one for the other. Breast Metastasis is Rare Pleural mesothelioma occurs on the membrane that surrounds the lungs. It is rare for mesothelioma to spread to the breast. The most common place for mesothelioma cells to spread is the lungs. Women … Continue reading Breast Cancer and Mesothelioma: Case Study Illustrates Diagnostic Challenge»
Mesothelioma and Lung Cancer: These Biomarkers Can Tell the Difference-Researchers in Canada say when it comes to distinguishing between mesothelioma and lung cancer, some proteins are more valuable than others. The team has identified an especially important protein biomarker for mesothelioma. A biomarker is a compound in body fluid or tissue that can act as a signpost for disease. Understanding the value of this particular protein as compared to other biomarkers may improve the testing process for mesothelioma. Pleural mesothelioma and lung cancer share many of the same characteristics. Both affect the lungs and both cause similar symptoms. But they are treated differently. It is not always easy to tell these two cancers apart, even with high-level diagnostic tools. But the biomarker testing completed in Canada may make it … Continue reading Mesothelioma and Lung Cancer: These Biomarkers Can Tell the Difference»
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