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15

NCCN Guidelines for Patients

®

:

Malignant Pleural Mesothelioma, Version 1.2016

2

Testing for mesothelioma

How is mesothelioma found?

Thoracentesis

To confirm if there’s cancer, a sample of tissue or

fluid must be removed from your body for testing.

This is called a biopsy. Thoracentesis is a type

of biopsy that removes a sample of fluid from the

pleural cavity.

See Figure 4

. For thoracentesis

your skin will be cleaned and numbed with local

anesthesia. Next, a needle will be inserted between

your ribs into your chest to get the fluid. You may be

given an x-ray before the biopsy to guide the needle

into your chest and afterward to check if the biopsy

went well. The fluid sample will then be sent to a lab

to be tested for cancer cells. It is difficult to diagnose

mesothelioma just by testing the fluid since cancer

cells are often not seen.

Pleural biopsy

A pleural biopsy removes one or more samples of

the pleura. The tissue samples are then sent to a

lab to be tested for cancer cells. There are a few

ways that a pleural biopsy can be done. Options

include a CT-guided core biopsy, an Abrams needle

biopsy, an open biopsy, or a thoracoscopic biopsy.

Thoracoscopic biopsy is the preferred method.

CT-guided core biopsy

A CT-guided core biopsy uses pictures from a CT

scan to guide a needle into your body. First, your skin

will be cleaned and numbed with local anesthesia.

Next, the needle will be inserted through a small

cut and guided into your chest between your ribs.

Then, the sample will be removed by the sharp end

of the needle and stored in a hollow space within the

needle.

Abrams needle biopsy

An Abrams needle biopsy is like a core biopsy.

However, it may or may not use CT. An Abrams

needle limits the amount of air that enters tissue

during a pleural biopsy.

Open biopsy

An open biopsy requires a surgical cut into the chest.

General anesthesia, a controlled loss of wakefulness

from drugs, is used. The larger cut allows the

surgeon to see into your chest without any tools.

Tissue samples are collected with a surgical knife.

For this biopsy, you will have to stay in the hospital

overnight.

Figure 4

Thoracentesis

Thoracentesis is a type of biopsy

that removes a sample of fluid from

the pleural cavity to test for cancer

cells. The pleural cavity is the space

between the two layers of tissue

lining around the lungs.

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