From the blog

Techniques for Determining a Mesothelioma Diagnosis

Published: May 21, 2018

If you have been exposed to asbestos and are exhibiting symptoms of mesothelioma including: pain in the side of your chest and lower back, shortness of breath, cough, fever, excessive sweating, fatigue, random weight loss, not being able to swallow, being hoarse, or have face and arm swelling it might be a good idea to go to a doctor and be tested. This is important because the sooner you are diagnosed the sooner you can begin treatment to improve and extend your life as much as possible.

Since the only known cause of mesothelioma is exposure to asbestos, it’s important to mention to your physician your possible past exposure to asbestos during an examination. This will prompt the doctor to administer various tests to determine a mesothelioma diagnosis.

Imaging Tests

As a first step in diagnosing the disease, the doctor may order x-rays, computed tomography (CT) scans, positron emission tomography (PET) scans, and magnetic resonance imaging (MRI) scans.  During a chest x-ray, the doctor may be able to determine if the pleura (the membrane that lines the lungs) is abnormally thick, contains calcium deposits, or if there is fluid between the lung and the chest.  A CT scan is similar to an x-ray but it creates a more advanced image using cross sections of the body and combining them into one large image. This can be used to better determine the extent and location of the cancer. PET scans can also be very useful even though they are not as detailed as CT Scans. To do a PET scan a patient is injected with a radioactive substance which is usually a type of sugar. Cancer cells grow quicker than healthy cells so they absorb more of the radioactive liquid which can then be seen on the scan.   The final imaging test is an MRI scan which uses radio waves and magnets to create detailed images of the body. In order to see details, a doctor will inject a contrast material called gadolinium. Like CT scans, MRI scans can help determine the location, size and tumor progression.


If tissue that is not normal is found, the doctor will need to cut out a small piece and have it reviewed under a microscope to see if there are any cancer cells. This is called a biopsy. The first way to biopsy is to remove fluid from the body to figure out what it is and see if it contains cancer. Thoracentesis is the removal of fluid from the chest, paracentesis is the removal of fluid from the abdomen, and pericardiocentesis is the removal of fluid from the sac around the heart. If no cancer is found within the fluid, it is still possible to have cancer and a further biopsy of the mesothelium, or lining of the abdomen, needs to be done.

Another type of biopsy is a needle biopsy, where a long needle guided by a CT scan is inserted into the area of the cancer to remove a sample. It is a less invasive test but may not be as accurate. Endoscopic biopsies can also be done where a camera with a tool at the end is used to view the biopsy site before removing tissue samples.

There are three types of endoscopic procedures depending on where they are performed:

  • Thorascopy- views inside the chest to inspect the lungs or pleura
  • Laparoscopy-views the organs inside the abdomen
  • Mediastinoscopy- views the mediastinum (area between the lungs in the middle of the chest)

The doctor can also perform an endobronchial ultrasound needle biopsy.  This is done by inserting a flexible fiber optic tube with an ultrasound device into the windpipe and allows the doctor to observe the lymph nodes. A needle is then inserted into the nodes to take samples for further tests. Finally, the doctor may perform an open surgical biopsy, where incisions are created in the chest or abdomen to remove large samples or even the whole tumor.

If you suspect you have mesothelioma it is important to see a medical professional as soon as possible for both the quality and longevity of your life. A combination of these tests can help doctors give an accurate diagnose so treatment options can be laid out for you.


 The American Cancer Society Medical and Editorial Content Team, “How is Malignant Mesothelioma Diagnosed?” American Cancer Society (February 17, 2016). [Link]

The American Cancer Society Medical and Editorial Content Team, “Signs and Symptoms of Mesothelioma,” American Cancer Society (February 17, 2016). [Link]

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