NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2016
Testing for mesothelioma
How is mesothelioma found?
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
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.
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
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.
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
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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