How to Diagnose Mesothelioma

A mesothelioma is a malignant tumor that originates from mesothelial cells that line the body cavities. It occurs in the pleura in 90 percent of cases and is usually caused by asbestos exposure. Mesotheliomas are classified by histology into three types: epithelial, mixed and sarcomatous. They usually occur in patients between 40 and 60 years; males are affected more often. The following steps will show how to diagnose a mesothelioma.

Difficulty: Challenging

Instructions

1. Expect the initial symptoms to be difficulty in breathing and chest pains. Other common symptoms include fatigue, fever, sweats and weight loss. Mesothelioma also may be asymptomatic and discovered only incidentally.

2. Conduct a physical examination to find fluid in the lungs that decreases after thoracentesis in 90 percent of mesothelioma cases. It also may manifest as brachial plexopathy, cord compression, Horner syndrome or superior vena cava syndrome in rare cases.

3. Base a diagnosis of older cell lines causing mesothelioma on a thorascopically guided biopsy. These results are confirmatory 98 percent of the time. The biopsy is carefully examined after staining with immunochemicals. A battery of tests such as anti-Leu M1, BerEP4, carcinoembryonic antigen, and human milk fat globulin 2 is commercially available for mesothelioma.

4. Distinguish mesothelioma from adenocarcinoma with positive tests for calretinin and negative results for periodic acid-Schiff stain and mucicarmine stain. Mesothelioma cells have long microvilli while adenocarcinomas have short microvilli.

5. Identify four new cell lines of mesothelioma with positive tests for cytokeratins 8 and 18, antigens recognized by HBME-1 monoclonal antibodies and vimentin.

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