|
|
| Line 4: |
Line 4: |
| ==Overview== | | ==Overview== |
| ==Laboratory Findings== | | ==Laboratory Findings== |
| Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of 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 often [[spirometry|lung function tests]]. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A [[computed tomography|CT]] (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by [[cytology]] if this fluid is [[Needle aspiration biopsy|aspirated]] with a syringe. For pleural fluid this is done by a [[pleural tap]] or [[chest drain]], in ascites with an [[paracentesis]] or ascitic drain and in a pericardial effusion with [[pericardiocentesis]]. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. [[tuberculosis]], [[heart failure]]).
| |
|
| |
|
| If cytology is positive or a plaque is regarded as suspicious, a [[biopsy]] is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a [[histopathology|pathologist]]. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a [[thoracoscopy]]. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
| |
|
| |
| If the cancer is in the abdomen, the doctor may perform a [[laparoscopy]]. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
| |
|
| |
| {| border="1" cellpadding="5" cellspacing="0" align="center"
| |
| |+'''Typical [[immunohistochemistry]] results'''
| |
| |-
| |
| |style="width:300px"|'''Positive'''
| |
| |style="width:300px"|'''Negative'''
| |
| |-
| |
| |EMA (epithelial membrane antigen) in a membranous distribution
| |
| |CEA ([[carcinoembryonic antigen]])
| |
| |-
| |
| |WT1 (Wilms' tumour 1)
| |
| |B72.3
| |
| |-
| |
| |Calretinin
| |
| |MOC-3 1
| |
| |-
| |
| |Mesothelin-1
| |
| |CD15
| |
| |-
| |
| |Cytokeratin 5/6
| |
| |Ber-EP4
| |
| |-
| |
| |HBME-1 (human mesothelial cell 1)
| |
| |TTF-1 ([[thyroid transcription factor-1]])
| |
| |}
| |
|
| |
|
| ==References== | | ==References== |