In many cases, it is very difficult to distinguish between pleural mesothelioma and lung cancer, hence the importance in many cases further tests on the part of the tumor or a biopsy and immunohistochemistry.
There are many tests and processes involved in the process of detection of the disease, these include:
For diagnosing the following tests are used:
1. Medical interview and physical examination. The doctor will ask if there has been exposure to asbestos.
2. Chest radiography and CT of the chest-abdomen gives more precise information about the size, shape and position of a tumor, and can help detect enlarged lymph nodes in size. The CT scans are more sensitive than routine chest radiographs to detect tumors at earlier stages.
3. Spirometry study of respiratory function.
4. Blood tests that will meet the general condition of the patient and detect abnormalities in kidney or liver function.
Blood tests also have the ability to detect cancer mesothelioma in the pleura. However, these tests (blood that scan to find specific proteins) are not yet so advanced as to be 100% reliable.
5. Biopsy: The removal of cells from the pleura or peritoneum to analyze the presence or absence of signs of cancer.
The procedures used to perform this biopsy are:
- Biopsy / direct needle aspiration (guided or not TAC): a needle is inserted into the mass while the lungs are displayed on a computer tomography. a sample of the mass is then extracted and observed by a microscope to see if it contains cancer cells.
- Thoracoscopy: a small cut between two ribs is given to insert a tube to observe the pleura and take a sample. If the cut is bigger (open surgery) it is called thoracotomy.
- Laparoscopy similar but made in the abdomen. If the cut is bigger (open surgery) it is called laparotomy.
The complete diagnosis can take between a few weeks to a few months. Very few patients are diagnosed in their first visit to the doctor and most patients visit multiple doctors before receiving news.
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