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Monday, March 23, 2009

Mesothelioma Diagnosis


Mesothelioma is a cancer of the lining of the lungs
Mesothelioma diagnosis include X-rays tissue fluid sampling CT, MRI and PET scans
Mesothelioma Diagnosis
DIFFERENTIAL DIAGNOSIS
Metastatic adenocarcinomas (from lung, breast, ovary, kidney, stomach, prostate)

WORKUP
• Staging evaluation includes complete history (including occupational history), physical examination, and testing to determine potential operability (CT, bone scan, PFTs)
• Thoracoscopy, pleuroscopy, and open lung biopsy are useful in obtaining adequate tissue samples for diagnosis
• Pulmonary function tests
• Staging: the UICC staging uses the TNM categories to organize mesothelioma in stages I-IV in a manner similar to that used for non–small cell lung cancer

Diagnosing Mesothelioma can be done through imaging techniques and tissue sampling to find and lung cancer
LABORATORY TESTS
• Diagnostic thoracentesis is generally insufficient for diagnosis because pleural effusions may only reveal atypical mesothelial cells

• Immunohistochemistry is useful to distinguish adenocarcinoma from epithelial malignant mesothelioma ( mesotheliomas are generally CEA negative and cytokeratin positive)
• Thrombocytosis and anemia may be found on initial lab evaluation

IMAGING STUDIES
• Chest radiographs may reveal pleural plaques or calcifications in the diaphragm
• CT scan of the chest/abdomen and bone scan are used to assess the extent of disease

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