1. One can start by reviewing the patient’s medical history. If he has a history of being exposed to asbestos, he is at greater risk for 2011 Mesothelioma.
2. A physical examination is a must.
3. The Cytology procedure can be effective in detecting if abnormal cell are present in the large amount of fluid. For pleural fluid, it is done with a pleural tap or chest drain, in ascites it is done with an ascitic drain, or paracentesis.
4. A biopsy is performed, to confirm the diagnosis. A sample of tissue is removed and observed under the microscope.
5. Imaging techniques have proved very effective in diagnosing Mesothelioma. For example, there is the X-ray, which reveals the fluid build-up, limited to either the right (60%) or left (40%) lung. Sometimes, a mass may be observed.
6. Computed Tomography (CT) scans are performed to define the pleural effusion, pleural thickening, pleural calcification, thickening of interlobular fissures, and possible chest wall invasion.
7. Magnetic Resonance Imaging (MRI) is performed to note the extent of the tumor, before aggressive treatment is carried out. These can provide images in multiple planes, so can identify tumors better. They are more accurate in checking the enlargement of the mediastinal lymph nodes, and the clear diaphragmatic surface.
8. Positron Emission Tomography (PET) is used to diagnose and evaluate Mesothelioma. However, they tend to be more expensive, and are usually not covered under insurance.
9. Integrated CT/PET imaging determines surgical eligibility in Mesothelioma cases. The benefits of CT and PET scans are combined into a single scan, thus the stage is accurately determined.
10. A needle biopsy of the mass can be made.
11. The removal and examination of the fluid surrounding the lung may be used to determine and diagnose the presence of Mesothelioma.
12. Open pleural biopsy is recommended as a diagnostic procedure – the surgeon makes a small incision through the chest wall, inserts a thin, lighted tube (thoracoscope) into the chest between two ribs. A sample tissue is removed, to be reviewed under a microscope.
13. Peritoneal biopsy is another method – the doctor will make a small incision in the abdomen. A peritoneoscope is inserted into the abdominal cavity.
14. Video Assisted Thoracoscopic Surgery (VATS) is widely used today. It is a minimally invasive procedure, that makes biopsies of the pleural lining, masses, nodules and pleural fluid.
15. Pleurodesis (talc) for pleural effusions can be carried out.
16. Thoracentesis is a pdiagnostic rocedure by which the doctor puts a needle into your chest, to gently use suction to drain out the accumulated fluid.
17. Peritoneoscopy allows the doctor to look inside the abdomen through a peritoneoscope, which is put into an opening made in your abdomen.
18. During the pathological examination, the tissue is described, and placed in a plastic cassette. It is important to know the patient’s information and history. The cassettes are stored so that the tissue can be preserved permanently. It is processed into a paraffin block, thus the pathologist can slice off thin microscopic sections, which he will stain and study, during the diagnosis.
19. The immunohistochemistry process allows the pathologist to analyze and identify the cell type based on the binding of antibodies to specific components of the cell.