How Is Pleural Mesothelioma Diagnosed?

How Is Pleural Mesothelioma Diagnosed?
How Is Pleural Mesothelioma Diagnosed?
Pleural mesothelioma is sometimes difficult to diagnose. Because many diseases of the lungs and respiratory system resemble symptoms of PM, doctors may mistake it for the flu or pneumonia without extensive testing.

The diagnostic process begins when a doctor, often a primary care physician, evaluates initial symptoms. Chest pain and breathing impairment warrant a chest X-ray, typically the first test to show fluid or tumors around the lungs.

Referral to a pulmonologist, oncologist or general hospital is common after an abnormal X-ray. Further imaging, blood tests and tissue biopsies are used to confirm a pleural mesothelioma diagnosis.

It is challenging for doctors to tell the difference between some cases of pleural mesothelioma and lung cancer. While doctors may suspect mesothelioma based on a patient's symptoms, history of asbestos exposure and abnormal imaging scan results, these signs are not enough to confirm a diagnosis.

The most reliable tool to diagnose the disease is a thoracoscopy. This minimally invasive procedure allows doctors to view the patient's chest through a small camera and collect a tissue sample, also known as a biopsy. A pathologist will evaluate the biopsy, distinguish the cancer’s cell type and confirm the diagnosis.

How Is Pleural Mesothelioma Diagnosed?
Diagnostic Imaging
After a review of medical and occupational history and a physical examination, patients typically undergo imaging tests that can reveal potentially cancerous tumors. There are three primary imaging tests used to diagnose pleural mesothelioma: Chest X-rays, CT scans and PET scans.
Chest X-raysX-rays reveal pleural effusions and pleural tumors in some cases.
CT ScansCT scans provide more advanced images that often show evidence of asbestos exposure.
PET ScansPET scans can detect signs of cancerous spread to the lymph nodes.
Using Biopsies & Other Tests for a Diagnosis

Other tests are needed to diagnose mesothelioma with a high level of confidence. A thoracentesis involves the insertion of a hollow needle into the lungs to collect pleural fluid when patients exhibit pleural effusions.

Pathologists examine fluid samples for biomarkers that indicate cancer. A thoracentesis provides an accurate diagnosis in 80 percent of cases.

When no fluid exists, doctors perform biopsies to collect pleural tissue samples. A thoracoscopic biopsy produces the most accurate diagnosis.

If a series of tests or biopsies confirm mesothelioma, doctors will develop a treatment plan based on those results.

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