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Mesothelioma Diagnosis Diagnosing mesothelioma is frequently hard, because the symptoms are comparable to those of a number of other conditions. Diagnosis begins having a review of the patient's medical history. A history of exposure to asbestos may possibly boost clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and usually lung function tests. The X-ray might reveal pleural thickening generally seen following asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is generally performed. If a large quantity of fluid is present, abnormal cells could be detected by cytopathology if this fluid is aspirated having a syringe. For pleural fluid, this is carried out by thoracentesis or tube thoracostomy (chest tube); for ascites, with paracentesis or ascitic drain; and for pericardial[disambiguation needed] effusion with pericardiocentesis. While absence of malignant cells on cytology does not fully exclude mesothelioma, it makes it a lot more unlikely, especially if an alternative diagnosis may be created (e.g. tuberculosis, heart failure). Unfortunately, the diagnosis of malignant mesothelioma by cytology alone is tough, even with professional pathologists.What Treatment for Mesothelioma Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A doctor removes a sample of tissue for examination below a microscope by a pathologist. A biopsy could possibly be carried out in diverse techniques, depending on where the abnormal region is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the physician makes a modest cut via the chest wall and puts a thin, lighted tube known as a thoracoscope into the chest among two ribs. Thoracoscopy permits the doctor to appear inside the chest and acquire tissue samples. Alternatively, the chest surgeon may well directly open the chest (thoracotomy). If the cancer is inside the abdomen, the physician could perform a laparoscopy. To acquire tissue for examination, the physician makes a modest incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield sufficient tissue, much more extensive diagnostic surgery may be required. Immunohistochemical studies play an important role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. You'll find numerous tests and panels accessible. No single test is best for distinguishing mesothelioma from carcinoma or even benign versus malignant. There are three histological forms of malignant mesothelioma: (1) Epithelioid; (2) Sarcomatoid; and (3) Biphasic (Mixed). Epithelioid comprises about 50-60% of malignant mesothelioma cases and normally holds a better prognosis than the Sarcomatoid or Biphasic subtypes. Staging Staging of mesothelioma is based on the recommendation by the International Mesothelioma Interest Group. TNM classification of the primary tumor, lymph node involvement, and distant metastasis is performed. Mesothelioma is staged Ia-IV (one-A to 4) according to the TNM status.