Needle Biopsy “Simple, Safe & Accurate” for Mesothelioma

Mesothelioma researchers in China say a biopsy method that involves a single skin puncture can produce good diagnostic results for mesothelioma patients with little pain or risk.

The study focused on percutaneous (through the skin) biopsy in patients who had unexplained fluid buildup or swelling in their abdomens. Abdominal distension and fluid buildup (called ascites) can be signs of peritoneal mesothelioma, a rare but aggressive cancer of the abdominal lining caused by exposure to asbestos. Peritoneal mesothelioma accounts for less than 30% of all mesothelioma cases. Because the symptoms may be vague and often develop many decades after asbestos exposure, peritoneal mesothelioma can be especially challenging to diagnose.  Misdiagnosis and under-diagnosis are not uncommon.

In the newest study on percutaneous needle biopsy, researchers analyzed the cases of 153 patients with unexplained ascites or abdominal swelling. All of the patients underwent ultrasound testing, a common first step in diagnosing mesothelioma and other abdominal cancers. When abnormalities were identified, the patients underwent percutaneous needle biopsies to obtain tissue samples. Accuracy was ensured by ultrasound guidance of the needle.

Of the 153 cases, 11 turned out to be mesothelioma. All of the biopsy procedures were successful and 91.5% produced tissue specimens that were considered “satisfactory” for testing. Ultrasound-guided percutaneous biopsy produced an overall diagnostic accuracy of 92.8% with no serious complications. Only 11 patients were unable to receive a diagnosis due to lack of sufficient tissue for testing.

In a summary of their findings in the World Journal of Surgical Oncology, the researchers concluded, “Ultrasound-guided percutaneous biopsy could be a simple, safe and accurate diagnostic method in patients with ascites and/or abdominal distension with unclear causes.” An earlier study conducted in Egypt reached a similar conclusion.

Along with imaging studies and biopsies, patients with peritoneal mesothelioma also undergo a thorough physical including a complete patient history. Because asbestos is the primary cause of this rare cancer, it is imperative that the physician be aware of the patient’s work history and possible exposure to this carcinogenic mineral.

Sources:

Wang,, J, et al, “A retrospective analysis on the diagnostic value of ultrasound-guided percutaneous biopsy for peritoneal lesions”, October 2, 2013, World Journal of Surgical Oncology, Epub ahead of print.
Allah, MH, et al, “Role of peritoneal ultrasonography and ultrasound-guided fine needle aspiration cytology/biopsy of extravisceral masses in the biagnosis of asvcietes of undetermined origin”, September 2012, Arab Journal of Gastroenterology, pp. 116-124.