Mesothelioma and Biopsy Procedures


If your symptoms include unexplained fluid accumulation in your chest area or abdomen, or /and you have a small to moderate amount of thickening of the pleura – then a biposy will be performed. The biopsy will be semi-invasive which will only require a local anesthetic and that does not involve cutting into the ches or abdomen. For example – the biopsy may involve a ‘thoracentesis’ (drainage of fluid from the chest), a ‘paracentesis‘ (drainage of fluid from the abdomen) or a ‘pleural biopsy’. These procedures are carried out by either a pulmonologist (lung physician), a radiologist, or a surgeon. A pleural biopsy may offer conclusive results as mesothelioma tends to be widely scattered in the chest, so a random sample of tissue may produce mesothelioma cells.

 

 

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Pleural Biopsy

The fluid and the tissue collected from the pleural biopsy will be sent to either a pathologist or cytologist. The cells will be examined under a microscope to determine whether mesothelioma is present. The fuid will be stained with a special fluid which will distinguish cancer cells from non-cancerous ones. This process is called ‘immunostaining’. After your biopsy – a chest xray is normally performed, this is to ensure that you have suffered no complications from the biopsy – such as accumulation of air in the chest (pneumothorax). This will also be able to predict whether enough fluid has been drawn from the chest – allowing for normal lung expansion.

Thoracoscopy

 If the semi-invasive test is inadequate or a CT scan reveals that fluid is not flowing freely but hidden in pockets that are difficult to reach – then A thoracoscopy (lighted scope) with or without connected camera, will be inserted into the chest cavity. If the physician sees any tissue that looks abnormal – a small piece of tissue will be cut out for inspection under a microscope.

Peritoneoscopy

A peritoneoscopy is similar to a thoracoscopy but involves close examination of the abdemen. If the radiolic tests indicate that there is more solid tumour than fluid – an open biopsy will be performed by a thoracic surgeon. He may remove a small piece of rib to allow a better view ogf the thickened pleura. A good size piece of the thickened pleura will be cut away (approx 1-1.5 diameter) to ensure an adequate diagnosis can be made. This procedure is carried out under general anesthetic and you may need some pain relief if you are experiencing any after pain or discomfort associated with the procedure.

Moreover – Sometimes physicians may want to give a dose of radiation to the sites where boipsies have been performed. This is because mesothelioma has a tendency to grow tumours at biopsy sites and the radiation will inhibit cell growth.