If you are experiencing symptoms of mesothelioma, your doctor will likely start by discussing your work history, performing a physical exam, and ordering imaging tests. Although these steps will help identify whether you have additional signs of the asbestos cancer, your doctor will ultimately need to do a biopsy to confirm a mesothelioma diagnosis.
A mesothelioma biopsy entails removing cells from the affected area of the body and examining them under a microscope. There are three mesothelioma biopsy types that your doctor may consider:
- Surgical biopsies are the most invasive and involve removing a large sample of the mesothelioma tumor or the whole tumor.
- Endoscopic biopsies use a thin tube with a tiny camera on the end to examine the affected tissue and take a sample for testing.
- Needle biopsies involve using a very thin needle to remove a sample of the tumor or fluid from the chest cavity, abdominal cavity, or heart sac.
Talk with your doctor about which mesothelioma biopsy type would be most effective in making an accurate diagnosis in your case. If you or a family member has already undergone a biopsy and been diagnosed with mesothelioma, you should know that financial help is available to get your family through this difficult time. Contact us today for more information on your legal options and for guidance on finding mesothelioma specialists near you.
Although they are the most invasive type of mesothelioma biopsy, open surgical biopsies are often necessary for your doctor to make a definitive diagnosis. Your doctor may also decide to combine a surgical biopsy with treatment, such as pleurodesis or a pleurex catheter to reduce fluid build-up around the lungs.
Thoracotomy involves your surgeon opening up your chest through an incision in the chest wall. The doctor will then either remove a significant sample of the tumor or attempt to take out the whole tumor.
Laparotomy involves a large incision in the abdominal wall so your doctor can examine the abdominal area, obtain a significant sample of the tumor, or try to remove the whole tumor.
Because surgical biopsies are much more invasive than needle biopsies and endoscopic biopsies, the recovery time is significantly more, often taking weeks or months.
Endoscopes are slender, tube-shaped instruments with a small video camera and light on the tip to help guide them. Your doctor may use an endoscopic biopsy to examine spots inside the body and take tissue samples.
Thoracoscopies are used to examine and take samples of the pleural tissue lining the lungs and chest cavity. This procedure can also be used to take samples of lymph nodes in the area to check on whether the cancer is spreading.
Laparoscopies allow your doctor to examine the abdominal cavity and take tissue samples of any tumors.
Mediastinoscopies are used to take samples from the space between the lungs, known as the mediastinum. This is an area that contains lymph nodes, which your doctor may want to biopsy to determine whether the cancer has spread.
Bronchoscopies may also be used in some cases to obtain samples of lymph nodes near the lungs.
Endoscopic procedures require general anesthesia and must be done in the operating room, but they are not as invasive as surgical biopsies.
There are several types of needle biopsies, often referred to as fine needle aspirations, that may be used to help diagnose mesothelioma. For these tests, the doctor will numb a patch of your skin and then insert a thin needle. Some needle biopsies remove fluid that has built up in the body due to the cancer, and others take a sample of the tumor itself or nearby lymph nodes.
Thoracentesis is used to take a sample of fluid that has built up in the chest (a condition known as pleural effusion). This procedure can also be used to help ease a patient’s pain from the fluid build-up, which is a common symptom of pleural mesothelioma.
Paracentesis is used to take a sample of fluid that has built up in the abdomen (a condition known as ascites). It can also help relieve a patient’s discomfort in the abdominal area, a common symptom of peritoneal mesothelioma.
Pericardiocentesis is used to take a sample of fluid from the pericardial sac surrounding the heart. This type of fluid build-up is common in pericardial mesothelioma patients.
All of these outpatient procedures can be done at your doctor’s office or in a hospital setting. Your doctor may use imaging tests such as a CT scan or ultrasound to help direct the needle. Although these are the least invasive types of mesothelioma biopsies, the results may not be conclusive enough to make a mesothelioma diagnosis.
Testing Fluid and Tissue Samples
Once fluid or tissue samples have been taken, your doctor will send them to a lab to be examined under a microscope. The lab tests can determine whether cancer cells are present, as well as whether it is mesothelioma.
Histology tests are used on tissue samples. They use special stains to identify asbestos cancer cells. And once a mesothelioma diagnosis is made, a histology report will also indicate whether the cancer cells are epithelioid, sarcomatoid, or biphasic (a mix of the two).
Cytology tests are used on fluid samples, although these results are often not reliable enough to rule out mesothelioma.