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How Doctors Use Biopsies to Help Evaluate Malignant Mesothelioma

You may have tests on fluid and tissue taken from your chest cavity to help confirm your diagnosis. The tests you have depend on the location and size of the cancer. Each of these tests allows the doctor to remove fluid or a small sample of tissue called a biopsy. The doctor sends the samples to a lab where a specialized doctor, called a pathologist, looks at them under a microscope and checks for cancer cells. Your doctor may do one or more of the following tests:

  • Thoracoscopy. A doctor uses this technique to take a small sample from a tumor in your chest cavity. The doctor inserts a small lighted tube with a camera (called a thoracoscope) through a cut in the skin of your chest to look at the tumor. The doctor looks carefully at the lining of the inner part of your chest and the lining of your lung. Then he or she removes a piece of tissue from the tumor for the biopsy.

  • Laparoscopy. A doctor uses this technique to take a small sample from a tumor in your abdomen. The doctor inserts a small lighted tube with a camera (called a laparoscope) through a cut in the skin of your belly to look at the tumor. The doctor looks carefully at the lining of the inner part of your belly, the lining on your intestines, and your liver. The doctor takes a biopsy from a suspicious looking area.

  • Bronchoscopy. For this test, the doctor inserts a thin tube (called a bronchoscope) into your mouth, down your windpipe, and into the main air passages of your lungs. This tube allows the doctor to see if there are any tumors in your airways. The doctor can also take a tissue sample (biopsy) while doing this test.

  • Mediastinoscopy. For this test, the doctor inserts a tube through a cut in the skin and under your breastbone. This tube is called a mediastinoscope. He or she moves the tube down into your chest to see lymph nodes in the area and do a biopsy.

  • Thoracotomy. This is a type of surgery in which the doctor opens your chest to remove a larger piece of tissue from the tumor or the entire tumor. This procedure is often the best way to make a correct diagnosis of mesothelioma.

  • Laparotomy. This is a type of surgery in which the doctor opens your abdomen to remove a larger piece of tissue from the tumor or the entire tumor.

  • Thoracentesis, pericardiocentesis, and paracentesis. These procedures use a long, hollow needle inserted through the skin to remove fluid from the chest, from the sac around the heart, or from the abdomen, respectively.

It is hard to diagnose mesothelioma by looking at fluid or tissue samples because this cancer can look like other kinds of cancer. You may need more tests.