Biopsies

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

Mini-Tumors May Help Doctors Develop Personalized Mesothelioma Treatments - Doctors at Wake Forest University are using miniature lab-grown three dimensional tumors to test personalized mesothelioma treatments. The mini-tumors are known as organoids and are grown from biopsy tissue taken from patients diagnosed with mesothelioma. Researchers say they can serve as models to try out new mesothelioma therapies before using them on patients. “There is a need for model systems to help predict personalized responses to chemotherapeutics,” writes lead investigator Andrea R. Massocchi with the Wake Forest Institute for Regenerative Medicine. “We have microengineered 3D tumor organoids directly from fresh tumor biopsies to provide patient-specific models with which treatment optimization can be performed before initiation of therapy.” Personalized Medicine and Malignant Mesothelioma Precision medicine in an up-and-coming area of medicine … Continue reading Mini-Tumors May Help Doctors Develop Personalized Mesothelioma Treatments »

Thoracoscopy Deemed “Valuable and Safe” for Mesothelioma Patients - Pleural mesothelioma patients who are recommended for medical thoracoscopy can rest assured that the procedure is “a valuable and safe” diagnostic tool. That is the message from Chinese researchers after an analysis of nine years of medical thoracoscopies on more than 800 patients with malignant mesothelioma and other pleural cancers at a Beijing hospital. What is Medical Thoracoscopy? Medical thoracoscopy is a minimally invasive procedure that can help doctors diagnose or treat the symptoms of lung diseases like pleural mesothelioma. Mesothelioma is an especially difficult cancer to diagnose since many of its symptoms mimic those of other diseases, including lung cancer. Patients with thickening of their pleural membrane (where mesothelioma tumors start) or with excess lung fluid called pleural effusion … Continue reading Thoracoscopy Deemed “Valuable and Safe” for Mesothelioma Patients »

New Mesothelioma Study: Asbestos Fiber Burden Does Not Decline With Time - Mesothelioma has one of the longest latency periods of any disease. It is not unusual for patients to develop the asbestos cancer many decades after their last exposure to asbestos. Now, a new German study offers a more detailed explanation of why that is. Although the body is adept at ridding itself of many kinds of toxins, when asbestos fibers are inhaled or swallowed, their shape and size allow them to stay in the tissue indefinitely, causing inflammation that can eventually trigger malignant mesothelioma. The new study, published in the European Respiratory Journal, is the first to study to level of asbestos fibers in the tissue of several individuals over time. It proves that, contrary to some theories, the fiber … Continue reading New Mesothelioma Study: Asbestos Fiber Burden Does Not Decline With Time »

Cellular Factors Predict Survival in Epithelioid Mesothelioma Patients - A team of French scientists believe they have found a way to predict survival and help plan a treatment course for people with the epithelioid form of malignant pleural mesothelioma. Until now, mesothelioma histological subtype has been the only way to reliably predict mesothelioma prognosis based on pathology (cellular characteristics that can be seen under a microscope). But mesothelioma researchers at the University Hospital of Saint Etienne have identified several  subtle differences between epithelioid mesothelioma cells from different patients that may have an impact on their treatment outcomes. Histopathology and Mesothelioma Prognosis Histopathology is the study of changes in tissue caused by disease. In the case of pleural mesothelioma, exposure to asbestos can cause the healthy cells in a person’s … Continue reading Cellular Factors Predict Survival in Epithelioid Mesothelioma Patients »

Mesothelioma Diagnosis: Fluid Cytology Versus Biopsy - A mesothelioma diagnosis using pleural fluid is just as reliable at predicting survival as a diagnosis based on a tissue sample. That conclusion, published in a recent issue of the British Journal of Cancer, is based on an analysis of more than 2,000 cases of malignant mesothelioma over 42 years. Researchers from the University of Western Australia and Curtin University in Perth compared the survival rates and diagnostic methods used on mesothelioma patients in an effort to determine whether pathologists had correctly identified their subtypes. Their results suggest that they had, which is good news for patients. Subtypes of Malignant Mesothelioma There are three primary subtypes of malignant mesothelioma, an aggressive cancer usually caused by asbestos exposure. Epithelioid mesothelioma is … Continue reading Mesothelioma Diagnosis: Fluid Cytology Versus Biopsy »

New Mesothelioma Grading System May Lead to More Accurate Prognosis - A new method for determining the prognosis of people with peritoneal mesothelioma suggests that patients whose mesothelioma cells have certain characteristics may live as long as 12 years. A research team including scientists from Wake Forest Baptist Health in North Carolina, the University of Mississippi Medical Center, and Memorial Sloan Kettering Cancer Center in New York has developed the first two-tier grading system for malignant peritoneal mesothelioma, a rare form of a rare cancer. An estimated 10 to 30 percent of the approximately 3,000 people in the US diagnosed with mesothelioma each year have the peritoneal form of the disease. Like the pleural or lung-related form, peritoneal mesothelioma grows quickly, is resistant to treatment, and is associated with past exposure … Continue reading New Mesothelioma Grading System May Lead to More Accurate Prognosis »

Mesothelioma Subtype Unrelated to Source or Degree of Asbestos Exposure - The source or degree of a mesothelioma patient’s asbestos exposure does not appear to have a direct impact on what mesothelioma subtype they develop. That is according to the results of a newly-published study out of Australia, a country with one of the world’s highest rates of asbestos cancer. To make their determination, mesothelioma researchers reviewed malignant mesothelioma cases from the Western Australian Mesothelioma Registry between 1962 and 2012, comparing each patient’s subtype with their exposure history. Understanding Mesothelioma Subtypes Mesothelioma tumor subtypes are determined by subtle differences at the cellular level. Subtype is determined by examining mesothelioma cells under the microscope. Understanding mesothelioma subtypes is an important part of developing effective mesothelioma treatments since the different types respond differently to … Continue reading Mesothelioma Subtype Unrelated to Source or Degree of Asbestos Exposure »

Diagnosing Mesothelioma with Medical Thoracoscopy - Medical thoracoscopy, a procedure used to diagnose and treat pleural diseases such as malignant pleural mesothelioma, provides the information needed to make a diagnosis in about 80 percent of patients. That is up by more than 20 percent in the last three decades. In a newly published study, a team of Italian pulmonary medicine specialists say the procedure, which is also known as pleuroscopy, has steadily improved as doctors have gotten more adept at using it to diagnose mesothelioma and other thoracic malignancies. The Challenge of Mesothelioma Diagnosis Pleural mesothelioma, a virulent cancer that starts on the membrane surrounding the lungs, is notoriously difficult to diagnose. The symptoms of mesothelioma, which can include cough, chest pain, fatigue and shortness of … Continue reading Diagnosing Mesothelioma with Medical Thoracoscopy »

Most Mesothelioma Patients Don’t Need Preventive Radiotherapy after Pleural Intervention - Preventive radiotherapy may not be the best way to keep new tumors from growing at the site of pleural interventions in people with malignant pleural mesothelioma. That is the finding of a group of physician researchers in the UK, who tracked the outcomes of more than 200 mesothelioma patients from institutes across the country who had procedures that required the use of a large-bore pleural tube. Pleural Interventions in Mesothelioma Pleural mesothelioma is a virulent cancer that occurs on the membrane that encircles and encases the lungs. Any procedure or surgery that involves using medical equipment in this region constitutes a pleural intervention.  Mesothelioma patients may need all kinds of pleural interventions, from surgeries to remove the bulk of their … Continue reading Most Mesothelioma Patients Don’t Need Preventive Radiotherapy after Pleural Intervention »

Preventing New Tumor “Seeding” After Mesothelioma Biopsy - Doctors in England are testing a method they hope will reduce the likelihood of pleural mesothelioma patients developing new tumors in their chest wall after a biopsy. A tissue sample is required to make a definitive mesothelioma diagnosis. But as many as 15 percent of mesothelioma patients who undergo some kind of invasive biopsy procedure will develop tiny new tumors along the tracks of the intervention site. Now, doctors at medical centers across England are performing the first randomized trial of prophylactic irradiation of those intervention sites as a way of preventing new mesothelioma tumors. Mesothelioma Biopsy Options There is no blood test for mesothelioma. Instead, patients suspected of having the asbestos cancer will undergo a thorough exam, a health … Continue reading Preventing New Tumor “Seeding” After Mesothelioma Biopsy »