A patient was diagnosed with malignant pleural mesothelioma using a new technique. Her doctors used endobronchial ultrasound and endoscopic ultrasound-guided biopsy at the same time.
These two techniques are less invasive than the usual diagnostic procedures. This could be helpful for diagnosing mesothelioma patients who are in poor health.
Signs of Cancer
Mesothelioma, an asbestos-linked malignancy that starts on the membrane around the lungs, can be difficult to diagnose. Mesothelioma diagnosis usually involves several tests. Patients may have imaging scans, blood tests, and a biopsy. By the time mesothelioma is finally diagnosed, it may already be too late for treatment to help.
A 48-year-old woman went to the hospital because she had been experiencing shortness of breath and coughing for several months.
Her doctor performed a CT scan of her chest. CT scans take many X-rays from different planes or cross-sections and create a three-dimensional image. This woman’s CT scan showed a possibly cancerous area in her chest.
The CT scan was followed by a PET/CT scan. This type of scan uses a special kind of dye that has radioactive tracers. Your organs and tissues absorb the tracer. When highlighted under a PET scanner, the tracers help your doctor see how well your organs and tissues are working. In this case, the PET/CT scan showed more signs of cancer in the patient’s chest.
The patient’s doctors needed to reach a diagnosis. They decided to use endoscopic ultrasound-guided biopsy with endobronchial ultrasound. This less invasive diagnostic method helped the doctors to realize that the patient had mesothelioma.
Gold Standard for Diagnosis
The gold standard for mesothelioma diagnosis is surgical biopsy of the suspected cancer site in the body. It has the highest rate of successful diagnosis compared to other methods.
Surgical biopsy can also cause complications like bleeding in the chest, air leak, and respiratory failure. This type of diagnostic method cannot be used on patients who are already in poor health.
The two diagnostic methods used in this case study are non-invasive. As of January 2021, there were only nine other reported cases of these two methods being used to diagnose mesothelioma.
The researchers in this study want doctors who work with mesothelioma patients to consider using endobronchial ultrasound and endoscopic ultrasound-guided biopsy to diagnose more fragile patients.
Mankidy B, Sparkman J, Boddu S, Huang Q, Sharma M. Simultaneous Use of Endobronchial and Endoscopic Ultrasound Guidance as Primary Tools in the Diagnosis of Malignant Pleural Mesothelioma. Cureus. 2022;14(12):e32110. Published 2022 Dec 1. doi:10.7759/cureus.32110. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805368/