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Mesothelioma Diagnosis Diagnosing mesothelioma is frequently difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins having a evaluation of the patient's medical history. A history of exposure to asbestos might enhance clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may possibly reveal pleural thickening commonly observed after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is typically performed. If a large amount of fluid is present, abnormal cells could 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 a lot more unlikely, particularly if an option diagnosis may be created (e.g. tuberculosis, heart failure). However, the diagnosis of malignant mesothelioma by cytology alone is challenging, even with professional pathologists.Mesothelioma Treatments Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A doctor removes a sample of tissue for examination below a microscope by a pathologist. A biopsy might be accomplished in different methods, based on exactly where the abnormal location is situated. If the cancer is inside the chest, the doctor may possibly carry out a thoracoscopy. In this procedure, the physician makes a little cut by means of the chest wall and puts a thin, lighted tube named a thoracoscope into the chest in between two ribs. Thoracoscopy permits the doctor to look inside the chest and acquire tissue samples. Alternatively, the chest surgeon might directly open the chest (thoracotomy). If the cancer is inside the abdomen, the doctor might perform a laparoscopy. To acquire tissue for examination, the physician makes a tiny incision within the abdomen and inserts a unique instrument into the abdominal cavity. If these procedures don't yield enough tissue, a lot more extensive diagnostic surgery might be essential. Immunohistochemical studies play an critical role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. You'll find many tests and panels accessible. No single test is perfect for distinguishing mesothelioma from carcinoma or even benign versus malignant. There are 3 histological varieties of malignant mesothelioma: (1) Epithelioid; (two) Sarcomatoid; and (three) Biphasic (Mixed). Epithelioid comprises about 50-60% of malignant mesothelioma cases and typically holds a much 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) according to the TNM status.