NCCN Guidelines for Patients® | Malignant Pleural Mesothelioma - page 17

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NCCN Guidelines for Patients
®
: Malignant Pleural Mesothelioma
Version 1.2012
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Part 4: Treatment planning
Samples of these lymph nodes can be obtained by mediastinoscopy. For this biopsy, a
mediastinoscope is inserted through a small cut in your neck right above your sternum.
A mediastinoscope is a thin, tube-shaped instrument that has a light and camera for
viewing as well as a tool to remove a sample. General anesthesia is used. General
anesthesia is a controlled loss of wakefulness from drugs. This surgery may cause
some pain and swelling and will leave a small scar.
EBUS-FNA
This is another way to perform a biopsy of the mediastinal lymph nodes. However,
EBUS-FNA doesn’t require any surgical cuts. During an EBUS-FNA, a bronchoscope
attached to an ultrasound device is guided down your throat into your lungs. The
ultrasound is used to find the lymph nodes. Next, a very thin needle is passed through
the wall of a main airway of the lungs and into a lymph node to get a sample.
MRI
MRI is an imaging test that uses radio waves and powerful magnets. It shows soft
tissues better than a CT scan. An MRI scan of your chest can show if the cancer has
spread to your chest wall, spine, diaphragm, or blood vessels. The scan may cause
your body to feel a bit warm. Like a CT scan, a contrast dye may be used.
VATS and laparoscopy
VATS is a type of biopsy, also called thoracoscopic biopsy. At least two small cuts are
made between your ribs into your chest. A thoracoscope to see inside your chest is
inserted through one cut. Surgical tools are inserted through the other cuts to remove
samples of the pleura, lymph nodes, or other tissue. Laparoscopy is a type of surgery
to view and take biopsy samples of organs and tissue in the abdomen (belly). A
laparoscope is inserted through a tiny cut in your abdomen. A laparoscope is a thin,
lighted tube with a lens for viewing and tools to remove samples of tissue. These
procedures are recommended if imaging tests suggest that there is mesothelioma in
the pleura (tissue lining the lungs) on both sides of your chest or in the peritoneum
(tissue lining the abdomen).
Definitions
Biopsy:
Removal of small
amounts of tissue or fluid to
be tested for disease
Bronchoscope:
Thin, long
tube fitted with tools that is
guided down the throat
Chest wall:
The layer of
muscles and bones under
the skin covering the chest
Diaphragm:
A sheet of
muscles below the ribs that
helps a person to breathe
Lymph nodes:
Small
groups of disease-fighting
cells located throughout the
body
Thoracoscope:
Thin tube
with a light, lens, and tools
to see and remove samples
of tissue from the chest
Ultrasound:
A test that
uses sound waves to take
pictures of inside the body
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