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Mesothelioma Diagnosis Diagnosing mesothelioma is often hard, simply because the symptoms are similar to those of several other conditions. Diagnosis begins having a review of the patient's medical history. A history of exposure to asbestos might improve 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 usually performed. If a big 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 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 totally exclude mesothelioma, it makes it much much more unlikely, particularly if an option diagnosis might be made (e.g. tuberculosis, heart failure). Regrettably, the diagnosis of malignant mesothelioma by cytology alone is challenging, even with expert pathologists.All Mesothelioma Treatments Generally, a biopsy is necessary to confirm a diagnosis of malignant mesothelioma. A doctor removes a sample of tissue for examination below a microscope by a pathologist. A biopsy may be carried out in distinct ways, based on exactly where the abnormal area is located. If the cancer is in the chest, the doctor could carry out a thoracoscopy. In this process, the physician makes a little cut via the chest wall and puts a thin, lighted tube known as a thoracoscope into the chest between two ribs. Thoracoscopy makes it possible for the physician to look inside the chest and obtain tissue samples. Alternatively, the chest surgeon might directly open the chest (thoracotomy). If the cancer is in the abdomen, the physician might perform a laparoscopy. To acquire tissue for examination, the physician makes a little incision within the abdomen and inserts a unique instrument into the abdominal cavity. If these procedures don't yield enough tissue, more extensive diagnostic surgery may be necessary. Immunohistochemical studies play an critical role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. You will find several 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; (2) Sarcomatoid; and (3) 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 main tumor, lymph node involvement, and distant metastasis is performed. Mesothelioma is staged Ia-IV (one-A to four) based on the TNM status.