How Is It Diagnosed?

Sometimes it is hard to tell the difference between malignant pleural mesothelioma and lung cancer, so tests are performed to examine the inside of the chest to accurately diagnose the condition.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the person's health habits, exposure to asbestos, past illnesses, and treatments will also be taken.

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:

The number of red blood cells, white blood cells, and platelets
The amount of hemoglobin (the protein that carries oxygen) in the red blood cells
The portion of the blood sample made up of red blood cells.

Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.

Biopsy: The removal of cells or tissues from the pleura so they can be viewed under a microscope by a pathologist to check for signs of malignant pleural mesothelioma. Procedures used to collect the cells or tissues include the following:

Fine-needle aspiration biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. This procedure is also called a needle biopsy.

Thoracoscopy: An incision (cut) is made between two ribs, and a thoracoscope (a thin, lighted tube) is inserted into the chest.

Peritoneoscopy: An incision is made in the abdominal wall and a peritoneoscope (a thin, lighted tube) is inserted into the abdomen.

Laparotomy: An incision is made in the wall of the abdomen (stomach) to check the inside of the abdomen for signs of disease.

Thoracotomy: An incision is made between two ribs to check inside the chest for signs of disease.

Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.

Cytologic exam: An examination of cells under a microscope by a pathologist to check for anything abnormal. When checking for malignant pleural mesothelioma, fluid is taken from around the lungs. A pathologist checks the cells in the fluid.

After a malignant pleural mesothelioma diagnosis is confirmed, additional tests will be performed in order to determine the stage of the cancer.