Mesothelioma Diagnosis Steps


Diagnosing mesothelioma, a type of cancer primarily associated with asbestos exposure, involves a multi-step process due to its rarity and the similarity of its symptoms to other conditions. Here’s a breakdown of the diagnostic steps:

1. Patient History and Physical Examination

The initial step often includes a detailed patient history to check for possible exposure to asbestos and a physical examination to identify any signs indicative of mesothelioma, such as lumps under the skin on the chest.

2. Imaging Tests

Imaging tests help to visualize the chest and abdomen, identifying tumors and determining their extent. Common imaging tests include:

  • Chest X-ray: Can show thickening of the pleura, fluid, or changes in the lungs.
  • CT scans (Computed Tomography): Provide detailed cross-sectional images of the body, detecting tumors and helping to determine the stage of the cancer.
  • MRI scans (Magnetic Resonance Imaging): Offer detailed images of soft tissues, useful for assessing the cancer’s spread and planning surgery.
  • PET scans (Positron Emission Tomography): Help to show cancerous cells’ activity levels and can be used in combination with a CT scan (PET/CT scan) for more detailed images.

3. Blood Tests

Blood tests can’t diagnose mesothelioma definitively but can detect biomarkers (such as soluble mesothelin-related peptides (SMRPs)) that are often higher in people with mesothelioma. These tests can support a diagnosis and are used more for monitoring the disease’s progression or response to treatment rather than for diagnosis.

4. Biopsies

Biopsies are the only way to confirm a diagnosis of mesothelioma definitively. There are different types of biopsies that may be used, depending on the location of the suspected cancer:

  • Fine Needle Aspiration (FNA): A thin needle is used to remove fluid or tissue from the affected area.
  • Thoracoscopy/Laparoscopy: Minimally invasive surgeries that allow a doctor to look inside the chest or abdomen and take tissue samples. These procedures are often done under general anesthesia.
  • Thoracotomy/Laparotomy: More invasive surgical procedures to open the chest or abdomen to take tissue samples or remove tumors.

5. Pathological Examination

The biopsy samples are examined under a microscope by a pathologist to look for cancer cells. Special stains and tests may be used to differentiate mesothelioma from other conditions and to determine the type of mesothelioma (epithelioid, sarcomatoid, or biphasic).

6. Staging

Once mesothelioma is diagnosed, additional tests may be conducted to determine the stage of the disease, which is crucial for planning treatment.

The process can be complex and may require the expertise of a team of specialists, including thoracic surgeons, oncologists, radiologists, and pathologists, to ensure an accurate diagnosis and appropriate treatment plan.