Diagnosis

Diagnosis of mesothelioma is very difficult, as the patient will show no abnormal signs during the early stages. Its symptoms are very similar to lung disease and cancer. The major dilemma with this is that it takes a minimum of fifteen to twenty years to see the disease in its full strength. There are several imaging techniques used to confirm the presence of mesothelioma especially in case of people who have asbestos related professions.

Some of the imaging techniques are:

X-ray - A chest x-ray can reveal pleural effusion (fluid build-up) which is confined to either the right (60%) or left (40%) lung. Sometimes a mass may be seen.

Computed tomography (CT) - CT scans are used to define pleural effusion or pleural thickening, pleural calcification, thickening of interlobular fissures or possible chest wall invasion. CT scans are also valuable in guiding fine needle aspiration of pleural masses for tissue diagnosis. It is originally known as Computed Axial Tomography (CAT).

Magnetic Resonance Imaging (MRI – MRI scans are used for identifying the treatment to be used rather than the presence of mesothelioma. Because they provide images in multiple planes, so it’s better to determine the extent of tumors as opposed to normal structures. They are more accurate than CT scans in assessing enlargement nodes. Both CT and MRI play an important role in surgical candidacy.

Positron Emission Tomography (PET) - PET imaging is now becoming an important part of the diagnosis and evaluation of mesothelioma. While PET scans are more expensive, they are the most diagnostic of tumor sites as well as the most superior in determining the staging of mesothelioma.

Thoracoscopy - For pleural mesothelioma a special instrument called a thoracoscope is used to look inside the chest cavity. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. If fluid has collected in the chest, it will be drained out of your body by inserting a needle into the chest and using gentle suction to remove the fluid. This process is called thoracentesis.

Peritoneoscopy - For peritoneal mesothelioma a peritoneoscope is used to look inside the abdomen. The peritoneoscope is put into an opening made in the abdomen. If fluid has collected in your abdomen inserting a needle into the abdomen and using gentle suction to remove the fluid drain it out. This process is called paracentesis.

Biopsy - If any abnormal tissue is found, the doctor will need to cut out a small piece and have to look at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy. It can also be done during surgery.

It is also important to know if the mesothelioma is localized or has spread to other parts of the body. This is because all these factors contribute to planning the treatment to be given to the patient.