A Mesothelioma Lung Cancer Diagnosis

How Mesothelioma is Diagnosed

The process for diagnosing mesothelioma includes multiple steps and usually takes from 3 to 6 months after the patient’s initial consultation with a primary care physician to discuss the symptoms being experienced. After considering the patient’s symptoms, the primary doctor will first ask for a full medical history and perform a thorough physical examination, checking for possible causes of the symptoms.

The primary care physician will usually check for signs of fluid buildup in the lungs, pleural effusion or pleural mass, reduced breathing and chest expansion capabilities, pulmonary functioning, and any noticeable lumps or tumors.

It’s vitally important to inform your doctor if you have suspected or known prior exposure to asbestos anywhere in your past. Symptoms of mesothelioma do not appear instantaneously but can take ten to fifty years to develop. Therefore your asbestos exposure could have occurred decades before the symptoms of asbestos cancer become noticeable.

If your doctor suspects asbestos related illness, consultation with a mesothelioma specialist or oncologists who specializes in occupational diseases and further tests will be called for.

Pathological Diagnosis of Mesothelioma

Pathology is the scientific study of a disease. When doctors diagnose a particular form of mesothelioma, they are looking at tissues under a microscope and relying on the science of pathology to understand what makes one case of mesothelioma different from another. Since mesothelioma is a highly complicated disease, it is not always easy for doctors to do this. This is why patients will often face a delay between an examination and the release of information about their disease from their mesothelioma doctors. While waiting for a final diagnosis, it may be helpful for patients to know the basics of mesothelioma pathology.

The Histology of Mesothelioma

Histology means the way that tissue is formed. In cases of cancer like mesothelioma, the structure of tissue is changed so that it is harmful to the body. There are three different tissue structures that mesothelioma can have.

• Epithelioid: Epithelioid mesothelioma takes place in the epithelia, cells that form protective barriers around the internal organs.
• Sarcomatoid:  Sarcomatoid mesothelioma is much rarer and develops in connective tissues, such as tendons and bones. An even rarer type of sarcomatoid mesothelioma occurs in muscle tissue.
• Biphasic / Mixed: In reference to mesothelioma, biphasic means “both” so a biphasic mesothelioma diagnosis would mean that a victim has a mixture of both epithelioid and sarcomatoid.

Depending on how asbestos entered the body, where it rested, and how long it has been in place, mesothelioma tissues may have different ‘patterns’. When doctors talk about mesothelioma patterns, they are talking about the way that the asbestos is affecting the surrounding cells. Remember, cancer is the cells of your own body developing in ways that are harmful. These terms are hard to remember, but mesothelioma victims and their families should understand at least the basics about the most common types; we will discuss why further below.

• Tubular patterns:  the mesothelioma cells look like boxes, and each has a clear nucleus, or center, under the microscope. It is the way that they form together that makes them look a little like a tube.
• Papillary patterns:  look like stalks under the microscope. It is very rare for mesothelioma to take a clear papillary pattern. Most often a papillary pattern will be mixed with another type of pattern.
• Diffuse patterns:  do not have any specifically identifiable pattern, like tubes or stalks; they are unorganized growths.
• Deciduoid patterns:  have round or multi-sided cells with sharp borders and glassy-looking cell material.

In order to identify what type of tissue is affected and how the patterns are forming, doctors will perform a variety of tests on the cells under the microscope. These tests include:

• Staining, or putting special dyes on the slide to see how cells react. Different cell types react differently to these special dyes.
• Testing for different chemicals. The absence of certain chemicals in tissue can indicate specific characteristics of mesothelioma.
• Testing immune reaction. Types and patterns of mesothelioma react differently to antibodies, a body’s ‘protector’ cells. Introducing antibodies to a slide and observing what happens can help doctors diagnose mesothelioma.

Why Pathology and Histology Are Important

Different types of mesothelioma and the forms they take may make mesothelioma more or less likely to respond to a specific treatment. For example, sarcomatoid mesothelioma does not respond well to radiation therapy. This is why it is so important for doctors to perform these tests, even if it takes time. Mesothelioma victims should educate themselves about their disease and ask questions from their doctors to understand how best to treat this disease.