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Mesothelioma Diagnosis Diagnosing mesothelioma is usually challenging, because the symptoms are comparable to those of quite a few other conditions. Diagnosis begins with a evaluation of the patient's medical history. A history of exposure to asbestos may possibly improve clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and frequently lung function tests. The X-ray may reveal pleural thickening commonly seen right after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large quantity of fluid is present, abnormal cells might be detected by cytopathology if this fluid is aspirated with 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. Even though absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it considerably more unlikely, specifically if an alternative diagnosis could be made (e.g. tuberculosis, heart failure). However, the diagnosis of malignant mesothelioma by cytology alone is difficult, even with professional pathologists.Treatments Mesothelioma Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A physician removes a sample of tissue for examination under a microscope by a pathologist. A biopsy might be done in diverse techniques, depending on where the abnormal region is situated. If the cancer is inside the chest, the physician could perform a thoracoscopy. In this procedure, the doctor makes a small cut by way of the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy enables the doctor to look inside the chest and obtain tissue samples. Alternatively, the chest surgeon may directly open the chest (thoracotomy). If the cancer is in the abdomen, the physician might perform a laparoscopy. To obtain tissue for examination, the doctor makes a little incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures don't yield sufficient tissue, a lot more extensive diagnostic surgery could be essential. Immunohistochemical studies play an critical role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. You'll find several tests and panels offered. No single test is ideal for distinguishing mesothelioma from carcinoma or even benign versus malignant. There are 3 histological forms of malignant mesothelioma: (1) Epithelioid; (two) Sarcomatoid; and (3) Biphasic (Mixed). Epithelioid comprises about 50-60% of malignant mesothelioma instances and typically holds a greater 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 main tumor, lymph node involvement, and distant metastasis is performed. Mesothelioma is staged Ia-IV (one-A to four) based on the TNM status.