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Lung Disease & Respiratory Health Center

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Mesothelioma: Tests, Diagnosis, and Treatments

Mesothelioma Tests continued...

Biopsies. There are methods of removing tissue to be examined for mesothelioma. They include:

Needle Biopsy. This procedure involves inserting a long, hollow needle through the skin to remove a tiny piece of a tumor. Your doctor may use imaging tests to guide the needle into the tumor. In some cases, the sample may be too small to make a diagnosis and a more invasive procedure is needed.

Thoracoscopy, Laparoscopy, and Mediastinoscopy. In these procedures, the doctor inserts a thin, lighted scope through a small incision in the skin to see potential areas of mesothelioma. Small tools, inserted through additional incisions, can be used to remove pieces of tissue to examine under a microscope. The specific procedure depends on the area being examined.

  • Thoracoscopy examines the space between the lungs and chest wall
  • Laparoscopy examines the inside of the abdomen
  • Mediastinoscopy examines the center of the chest, around the heart

Surgical Biopsy. In some cases, more invasive procedures may be needed to get a large enough tissue sample to make a diagnosis. In that case, a surgeon may perform a thoracotomy (opening the chest cavity) or laparotomy (opening the abdominal cavity) to remove a larger sample of tumor or the whole tumor.

Bronchoscopic Biopsy. This procedure involves passing a long, thin, flexible tube down the throat to examine the airways for tumors. If a tumor is found, the doctor can remove a small sample of it through the tube.

Imaging Tests. These tests allow your doctor to view the inside of your body noninvasively. Imaging tests commonly used in mesothelioma diagnosis include:

  • Chest X-ray. An X-ray of the chest may show abnormal thickening of or calcium deposits on the lung lining, fluid in the space between the lungs and chest wall or changes in the lungs, which could suggest mesothelioma.
  • Computed Tomography (CT). The CT scan is a procedure that uses multiple X-rays and a computer to create detailed images of the inside of the body. CT scans are often used to look for signs of cancer, help determine the location of the cancer, and to check if the cancer has spread.
  • Positron Emission tomography (PET). This test involves giving an injection of a compound containing a radioactive atom and then taking pictures of the body. Cancer cells absorb large amounts of radioactive compound and show up brighter than normal tissue on the images. Doctors then focus further tests on these areas of potential cancer.
  • Magnetic resonance imaging (MRI). MRI scans use radio waves and strong magnets to make detailed images of the body. Because they provide detailed images of soft tissues, they may help your doctor determine the tumor's location. For mesotheliomas that involve the diaphragm (a dome-shaped muscle under the lungs), MRI scans may be particularly useful.

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