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How is mesothelioma
diagnosed?
Diagnosing mesothelioma is often difficult,
because the symptoms are similar to those of a number of other
conditions. Diagnosis begins with a review of the patient's
medical history. A history of exposure to asbestos may increase
clinical suspicion for mesothelioma. A physical examination is
performed, followed by chest X-ray and often lung function tests.
The X-ray may reveal pleural thickening commonly seen after
asbestos exposure and increases suspicion of mesothelioma. A CT
(or CAT) scan or an MRI is usually performed. If a large amount
of fluid is present, abnormal cells may be detected by cytology
if this fluid is aspirated with a syringe. For pleural fluid
this is done by a pleural tap or chest drain, in ascites with an
paracentesis or ascitic drain and in a pericardial effusion with
pericardiocentesis. While absence of malignant cells on cytology
does not completely exclude mesothelioma, it makes it much more
unlikely, especially if an alternative diagnosis can be made
(e.g. tuberculosis, heart failure). If cytology is positive or a
plaque is regarded as suspicious, a biopsy is needed to confirm
a diagnosis of mesothelioma. A doctor removes a sample of tissue
for examination under a microscope by a pathologist. A biopsy
may be done in different ways, depending on where the abnormal
area is located. If the cancer is in the chest, the doctor may
perform a thoracoscopy. In this procedure, the doctor makes a
small cut through the chest wall and puts a thin, lighted tube
called a thoracoscope into the chest between two ribs.
Thoracoscopy allows the doctor to look inside the chest and
obtain tissue samples. If the cancer is in the abdomen, the
doctor may perform a laparoscopy. To obtain tissue for
examination, the doctor makes a small opening in the abdomen and
inserts a special instrument into the abdominal cavity. If these
procedures do not yield enough tissue, more extensive diagnostic
surgery may be necessary.
Typical immunohistochemistry
results
|
Positive |
Negative |
| EMA (epithelial
membrane antigen) in a membranous distribution |
CEA (carcinoembryonic
antigen) |
| WT1 (Wilms'
tumour 1) |
B72.3 |
|
Calretinin |
MOC-3 1 |
|
Mesothelin-1 |
CD15 |
|
Cytokeratin 5/6 |
Ber-EP4 |
| HBME-1
(human mesothelial cell 1) |
TTF-1 (thyroid
transcription factor-1) |
Others Information:
- What is the mesothelium?
- How common is mesothelioma?
-
What
are the risk factors for mesothelioma?
- What are the symptoms of mesothelioma?
- How is mesothelioma diagnosed?
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