Mesothelioma other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
- Antibodies to cytokeratin proteins are positive, differentiating these neoplasms from many sarcomas but not adenocarcinomas.
- The absence of staining with CEA or Leu-M1 differentiates them from adenocarcinomas.
- Recent evidence shows that Wilms’ Tumor Antigen 1 may help differentiate mesothelioma from adenocarcinoma.
Other Diagnostic Studies
Laparoscopy, Thoracoscopy, and Pleuroscopy
- Thoracoscopy or pleuroscopy may help in the diagnosis of mesothelioma.[1]
- Laparoscopy may be used to diagnose and treat selected cases of well-differentiated papillary mesothelioma associated with pelvic endometriosis.[2]
Biopsy
- Biopsy is helpful in the diagnosis of mesothelioma.[3]
- Procedures performed for biopsy may include:[3]
- Fine-needle (FNA) aspiration biopsy of the lung
- Thoracoscopy
- Thoracotomy
- Peritoneoscopy
- Open biopsy
Position Emission Tomography
- Positron emission tomography is becoming useful in two clinical settings:[4]
- Differentiating between benign and malignant asbestos-related pleural thickening
- Assessing for nodal metastases
- In addition, there appears to be a correlation between the degree of FDG uptake and the biological aggressiveness of the tumor, which may help to guide treatment.[4]
Fluorescence In Situ Hybridization (FISH)
- FISH may be helpful in the diagnosis of mesothelioma. It helps in distinguishing malignant mesothelioma from reactive mesothelial cells in effusions.[5]
- Mutlitarget FISH assay may be used to detect chromosomal abberations (chromosomes 3, 7, 17, and 9p21).
- FISH technique may also be used to explore the alternative mechanism of tumor suppressor gene inactivation by methylation of p16, p14, and p15 gene in the pathogenesis of mesothelioma.[5]
References
- ↑ Alvarez JM, Hasani A, Segal A, Sterret G, Millward M, Nowak A; et al. (2009). "Bilateral thoracoscopy, mediastinoscopy and laparoscopy, in addition to CT, MRI and PET imaging, are essential to correctly stage and treat patients with mesothelioma prior to trimodality therapy". ANZ J Surg. 79 (10): 734–8. doi:10.1111/j.1445-2197.2009.05060.x. PMID 19878170.
- ↑ Nezhat FR, DeNoble SM, Brown DN, Shamshirsaz A, Hoehn D (2010). "Laparoscopic management of peritoneal mesothelioma associated with pelvic endometriosis". J Minim Invasive Gynecol. 17 (5): 646–50. doi:10.1016/j.jmig.2010.03.025. PMID 20728825.
- ↑ 3.0 3.1 Tests that examine the inside of the chest and abdomen are used to detect (find) and diagnose malignant mesothelioma. National cancer institute 2016. http://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq. Accessed on February 15, 2016
- ↑ 4.0 4.1 Radiographic findings of mesothelioma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/mesothelioma. Accessed on February 8, 2015
- ↑ 5.0 5.1 Savic S, Franco N, Grilli B, Barascud Ade V, Herzog M, Bode B; et al. (2010). "Fluorescence in situ hybridization in the definitive diagnosis of malignant mesothelioma in effusion cytology". Chest. 138 (1): 137–44. doi:10.1378/chest.09-1951. PMID 20139227.