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Mesothelioma Diagnosis Diagnosing mesothelioma is frequently difficult, because the symptoms are comparable to those of numerous other conditions. Diagnosis begins having a review of the patient's medical history. A history of exposure to asbestos may improve clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and typically lung function tests. The X-ray may possibly reveal pleural thickening commonly seen following asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is normally performed. If a big quantity of fluid is present, abnormal cells could possibly be detected by cytopathology if this fluid is aspirated having a syringe. For pleural fluid, this is done by thoracentesis or tube thoracostomy (chest tube); for ascites, with paracentesis or ascitic drain; and for pericardial[disambiguation needed] effusion with pericardiocentesis. Although absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, specially if an alternative diagnosis may be produced (e.g. tuberculosis, heart failure). However, the diagnosis of malignant mesothelioma by cytology alone is challenging, even with professional pathologists.How to Treat Mesothelioma Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A physician removes a sample of tissue for examination below a microscope by a pathologist. A biopsy could possibly be completed in various ways, based on where the abnormal region is situated. If the cancer is in the chest, the doctor may carry out a thoracoscopy. In this procedure, the physician makes a tiny cut by way of the chest wall and puts a thin, lighted tube referred to as a thoracoscope into the chest between two ribs. Thoracoscopy makes it possible for the doctor to appear inside the chest and obtain tissue samples. Alternatively, the chest surgeon may well directly open the chest (thoracotomy). If the cancer is within the abdomen, the physician may perform a laparoscopy. To acquire tissue for examination, the doctor makes a modest incision in the abdomen and inserts a unique instrument into the abdominal cavity. If these procedures do not yield enough tissue, a lot more extensive diagnostic surgery could possibly be needed. Immunohistochemical studies play an critical role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. You will find several tests and panels offered. No single test is best for distinguishing mesothelioma from carcinoma or even benign versus malignant. There are three histological varieties of malignant mesothelioma: (1) Epithelioid; (two) Sarcomatoid; and (three) Biphasic (Mixed). Epithelioid comprises about 50-60% of malignant mesothelioma cases and generally holds a better prognosis than the Sarcomatoid or Biphasic subtypes. Staging Staging of mesothelioma is according to 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 four) based on the TNM status.