If pleural mesothelioma is suspected, a pleural biopsy will be taken and analysed under a microscope to determine if the tissue is cancerous (malignant) or benign (not malignant).1 Pleural biopsies are also undertaken to help differentiate mesothelioma from metastatic adenocarcinoma or other diseases that exhibit similar symptoms.10 A pleural biopsy can be obtained in several ways including:1,11
A needle to withdraw tissue or fluid. This may be performed by a radiologist using either an ultrasound or CT scan to guide placement of the needle
An endoscope, which looks at the chest through a thin, lighted tube, inserted though the mouth. Doctors then use a tool to remove tissue samples through the tube to analyse whether they are cancerous
Surgery, a thoracoscopy-guided biopsy is most commonly used to diagnose pleural mesothelioma, which uses real-time imaging to identify the exact sampling point with adequate tissue for biopsy
Pleural fluid can be used to examine the cytology
Blood samples are taken and analysed to determine high or low levels of cells in a patient’s body that could be a sign of pleural mesothelioma (such as a high weight blood cell count).1,5
A clinical evaluation is the last step to diagnosing pleural mesothelioma and takes a holistic look at a patient’s physical condition, medical history and laboratory examinations (such as biopsy and blood test results) to confirm a diagnosis and prognosis
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