MESOTHELIOMA DIAGNOSIS: TESTS, BIOPSY, PATHOLOGY, CYTOLOGY AND RADIOLOGY

Mesothelioma is diagnosed and/or detected through a variety of methods including:

Radiology
Often mesothelioma is first detected, or suspected, after a chest X-ray or CT Scan is taken. However, a mesothelioma diagnosis cannot be made by radiology alone. Chest X-rays may reveal abnormalities consistent with mesothelioma. Tests, including CT Scans, provide more details than chest x-rays and are helpful in staging the cancer after the mesothelioma diagnosis is made. Among the abnormalities associated with mesothelioma that may be identified by chest X-rays or CT scans are pleural thickening and pleural effusions.

Cytology
Laboratory analysis of fluid from a pleural effusion is often the first diagnostic mesothelioma test used to determine whether a person has the cancer. Also, cytological examination of fluid often precedes a mesothelioma test, known as a biopsy, which is a more invasive technique. Mesothelioma may be diagnosed through cytological examination, particularly where it is combined with cytogenetic analysis of the fluid. However, positive cytology results should be confirmed if possible. This is done by way of a mesothelioma biopsy of tissue. Negative cytology results should also be followed with a biopsy, where mesothelioma is suspected, because cytological examination is not sensitive enough to catch many cases of mesothelioma. (See Renshaw et al., The Role of Cytologic Evaluation of Pleural Fluid in the Diagnosis of Malignant Mesothelioma, Clinical Investigations, Chest, January 1997).

Pathology
The most effective way to make a pleural mesothelioma diagnosis is through a biopsy of pleural tissue (or peritoneal tissue in the case of peritoneal mesothelioma tests); the more tissue that is examined, the more accurate the diagnosis. For cases of pleural mesothelioma, a transbronchial biopsy, which involves a tube inserted into the throat, does not require surgery, but only provides a small tissue sample. While less desirable, more invasive surgical procedures that provides a greater tissue sample will support a more accurate diagnosis. After a piece of tissue from the mesothelioma is removed from the body, the diagnosis of mesothelioma is made through well-established immunohistological staining performed by a pathologist. Asbestos litigation affords victims with a mesothelioma diagnosis the opportunity to receive financial compensation from corporations who caused the disease.

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