Dr. Hedy Lee Kindler, a medical oncologist and professor of medicine at the University of Chicago, explains
how mesothelioma is diagnosed and what
tests are used. For
pleural mesothelioma, diagnosis begins with a
physical exam and
imaging tests such as a chest X-ray, CT scan, PET scan, and sometimes an MRI. If fluid is present around the lungs, it may be drained and tested using a procedure called a
thoracentesis. However, a
biopsy is usually needed to confirm the diagnosis, often done using
image-guided techniques or a
thoracoscopy, which allows doctors to take multiple tissue samples. For
peritoneal mesothelioma, diagnosis also starts with a
physical exam and
imaging such as CT or MRI scans, and sometimes a PET scan. Fluid in the abdomen may be removed and analyzed using a procedure called a
paracentesis. A
biopsy is still required, either through
image-guided needle sampling or a
laparoscopy to collect tissue from the abdomen. In both pleural and peritoneal mesothelioma,
germline and somatic testing may be done to look for molecular changes that help guide treatment decisions.
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