How Is Mesothelioma Diagnosed?

By Alan Jogja

Diagnosis of mesothelioma is usually obtained with clinical findings and careful assessment of the radiological and biopsy tissue confirmation. Reviews patient medical history, including taking a history of asbestos exposure, followed by a complete physical examination, x-ray chest or abdomen and lung function tests. CT scan or MRI can also be done at this time. If one of the initial tests prove suspicious for mesothelioma, a biopsy is needed to confirm this diagnosis.

Imaging techniques and their Value in Diagnosing and Assessing Mesothelioma

There are several imaging techniques that may be useful when mesothelioma is suspected due to malignant pleural effusion combined with asbestos exposure or secondary employment history. While imaging techniques can be useful in assessing the likelihood of cancer, definitive diagnosis is still most often established through fluid diagnosis or tissue biopsy.

Some of the most frequently used imaging methods include:

X-ray

Chest X-ray can reveal pleural effusion (fluid build-ups) that limited both the right (% 60) or left (40%) lung. On that occasion, the mass can be seen. The signs of disease prior to non-cancerous asbestos, such as pleural plaques or pleural calcification, or scarring due to asbestosis may also be noted.

Computed Tomography (CT)

CT scans can also define pleural effusion, and pleural thickening, pleural calcification, thickening of interlobular crack, or possible chest wall invasion. CT, however, can not distinguish between changes associated with benign asbestos disease (pleural disease), or differentiate between adenocarcinoma of the lung that may have spread to the pleura mesothelioma verse. CT scans may also be valuable in guiding fine needle aspiration of pleural masses for tissue diagnosis.

Magnetic Resonance Imaging (MRI)

MRI scans are most often used to determine the size of the tumor prior to aggressive treatment. Because they provide multiple images in the plane, they are better able to identify tumors as opposed to the normal structure. They are also more accurate than CT scans in assessing enlargement of mediastinal lymph nodes (lymph nodes are located between the two lungs), and the diaphragm surface is clear, both of which play an important role in surgical candidacy.

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