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Mesothelioma (cont.)

How Do Specialists Diagnose Mesothelioma?

Imaging Studies

Chest X-ray: In people with mesothelioma, chest X-ray may show signs of mesothelioma. However, chest X-ray has limited usefulness because the findings of mesothelioma on chest X-ray are nonspecific and observed in other diseases as well.

CT scan: The findings of CT scan are similar to those of chest X-ray but are seen better and in more detail. CT is preferred for staging (evaluating the extent of) the tumor.

MRI: In some people, MRI complements the findings on CT scan. MRI provides better demonstration of soft tissues (better soft-tissue contrast) and may provide additional information not obtained from other studies.

Positron emission tomography (PET) scan: PET is a procedure in which a radiolabeled substance is used to measure the metabolic activity of the cells. Cancerous cells demonstrate increased metabolic activity. This procedure is being increasingly used to determine the size of the tumor and whether the tumor has spread.

Radiologic findings on X-ray, CT scan, and MRI cannot provide a clear diagnosis of mesothelioma. A history of asbestos exposure and radiologic findings may indicate the presence of mesothelioma, but it is important to stress that a diagnosis of mesothelioma cannot be made exclusively with imaging. Other diseases can look identical to mesothelioma radiographically. Tissue biopsy (a sample of cells is removed for examination under a microscope) is required for a definitive diagnosis.

Thoracoscopy: In this procedure, a small cut is made in the chest wall and a thoracoscope (flexible, lighted tube) is inserted between the two ribs. Thoracoscopy allows the health-care professional to look inside the chest and take tissue samples. A pathologist examines these samples for cancer cells. It provides a confirmatory diagnosis in 98% of people with mesothelioma.

How Do Doctors Determine Mesothelioma Staging?

When the diagnosis of mesothelioma is confirmed, the tumor stage is determined in order to plan the optimal treatment. Mesothelioma is broadly staged into two categories: localized (the tumor is restricted to the membrane surface where it originated) and advanced (spread to neighboring structures and distant organs and tissues).

Localized mesothelioma is also called stage I mesothelioma.

Advanced mesothelioma can be further classified into the following stages:

  • Stage II: The tumor has spread beyond the lining of the chest wall to lymph nodes in the chest.
  • Stage III: The tumor has spread into the chest wall, mediastinum (area of the chest between the lungs), heart, diaphragm (thin muscle below the lungs and heart that separates the chest from the abdomen and helps in breathing), or abdominal lining.
  • Stage IV: The tumor has spread to distant organs or tissues.
Medically Reviewed by a Doctor on 7/21/2016

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Read What Your Physician is Reading on Medscape

Mesothelioma »

Malignancies involving mesothelial cells that normally line the body cavities, including the pleura, peritoneum, pericardium, and testis, are known as malignant mesothelioma, which may be localized or diffuse.

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