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Mesothelioma Diagnosis Diagnosing mesothelioma is frequently challenging, simply because the symptoms are comparable to those of numerous other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and usually lung function tests. The X-ray may reveal pleural thickening commonly noticed after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is normally performed. If a significant amount of fluid is present, abnormal cells may be detected by cytopathology if this fluid is aspirated with a syringe. For pleural fluid, this is completed 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 doesn't completely exclude mesothelioma, it makes it considerably much more unlikely, especially if an alternative diagnosis could be produced (e.g. tuberculosis, heart failure). Unfortunately, the diagnosis of malignant mesothelioma by cytology alone is hard, even with professional pathologists.Treatments Mesothelioma Generally, a biopsy is necessary to confirm a diagnosis of malignant mesothelioma. A physician removes a sample of tissue for examination under a microscope by a pathologist. A biopsy might be carried out in diverse approaches, depending on exactly where the abnormal location is situated. If the cancer is in the chest, the physician may possibly carry out a thoracoscopy. In this procedure, the physician makes a little cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest in between two ribs. Thoracoscopy allows the physician to look inside the chest and obtain tissue samples. Alternatively, the chest surgeon may well directly open the chest (thoracotomy). If the cancer is in the abdomen, the doctor might perform a laparoscopy. To acquire tissue for examination, the physician makes a little incision inside the abdomen and inserts a unique instrument into the abdominal cavity. If these procedures do not yield sufficient tissue, much more extensive diagnostic surgery could be necessary. Immunohistochemical studies play an crucial role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics. You will find numerous tests and panels offered. No single test is perfect for distinguishing mesothelioma from carcinoma or even benign versus malignant. There are 3 histological kinds of malignant mesothelioma: (1) Epithelioid; (2) Sarcomatoid; and (three) Biphasic (Mixed). Epithelioid comprises about 50-60% of malignant mesothelioma cases and generally holds a far 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 4) according to the TNM status.