Mesothelioma Biopsy

A biopsy is one of the most precise means of detecting and identifying mesothelioma. This common diagnostic procedure is used to clarify whether a concerning lesion could be cancerous. Biopsies also enable doctors to identify distinct types of cancers.

Mesothelioma Biopsy
Defining Mesothelioma Biopsy

What is Mesothelioma Biopsy?

A biopsy is one of the most precise means of detecting and identifying mesothelioma.  This common diagnostic procedure is used to clarify whether a concerning lesion could be cancerous.  Biopsies also enable doctors to identify distinct types of cancers.

A biopsy involves a surgeon removing a sample of fluid or tissue from an area of concern.  The sample is then analyzed by a pathologist. The pathologist uses a microscope to look at the cells and determine the presence of cancer.

Blood tests and imaging scans are helpful tools which can aid in the identification of mesothelioma. The accuracy and precision these procedures continue to develop.  However, biopsy is the most accurate means of identification.

Mesothelioma is an extremely difficult cancer to detect and diagnose. Early symptoms mirror ordinary medical issues that are most often related to common benign illnesses. The cancer cells of mesothelioma often closely resemble the cancer cells of other forms of cancer.

Mesothelioma Biopsy

Mesothelioma Biopsy Facts

  • A suspicious tissue or fluid sample is surgically removed for analysis
  • A biopsy is essential for accurate diagnosis
  • VATS (Video-assisted thoracoscopic surgery) most common biopsy practice
  • Tissue and fluid cell extraction through a needle

Increasing the difficulty of accurate diagnosis, mesothelioma is comprised of three primary cell types each of which is linked to different prognoses. Disease progression is divided into four stages of cancer.  Stages are determined by how much the cancer has spread.

Accurate diagnosis can only be ensured by specialists in the field.  Pathologists and surgeons who are experienced and specialize in asbestos cancer.

Location and type of tumor determine the method of biopsy.  The invasiveness of the biopsy determines whether local or general anesthesia will be used.

Mesothelioma Biopsy Facts
What is Video-Assisted Thoracoscopic Surgery?

Video-Assisted Thoracoscopic Surgery (VATS)

VATS is a biopsy procedure in which surgeons use a medical instrument called an endoscope. An endoscope is a thin tubular instrument with a light and camera. It us used to look inside the body. It may have a tool attached for removing samples of tissue. Surgeons may also use the endoscope with other thin, less invasive instruments.

VATS is a preferred method of biopsy because it is minimally invasive. It does not require a major incision. Therefore, there is a shorter recovery time and minimal risk of complications.

Endoscopic Procedures

Types of Endoscopic Procedures are named after the area of focus

  • Thoracoscopy is an endoscopic procedure examining the chest cavity
  • Laparoscopy is an endoscopic procedure examining the abdominal cavity
  • Mediastinoscopy is an endoscopic procedure examining the region between the lungs

Thoracoscopic biopsy’s let surgeons see into the fluid filled space of the pleural cavity.  Thus, enabling surgeons to retrieve samples and determine the potential spread of cancer.

A 2008 study of 45 patients, with malignant mesothelioma, illustrates the success of thoracoscopy.  In this study, researchers looked at the accuracy of different biopsy techniques.    The use of thoracoscopy was found to have the greatest diagnostic accuracy.  Thoracoscopy’s confirmed diagnosis in 95 percent of the patients.

A pleurodesis procedure may be combined with a thoracoscopy.  This procedure involves the injection of a medication, which causes an inflammatory reaction, into the pleural space.  The area between the wall of the chest and the lung.

The goal of this procedure is to cause inflammation in the pleural space and therefore eliminating the ability of malignant fluid to re-accumulate around the lungs.

This procedure has been effective a 50 percent of the time.

Mesothelioma Biopsy

Other Biopsy Procedures for Mesothelioma

Due to the tumor location, or other potential complications, a thoracoscopy may not be possible.  Alternative biopsy procedures used for diagnosis involve thoracentesis or draining of fluid buildup.  Needle biopsy’s remove a sample of cells through a needle. Surgery to remove a tumor.

Draining Fluid Build-up

Thoracentesis is a procedure in which a hollow needle or cannula is used to remove fluid from the pleural space around the lungs.

This procedure removes fluid build-up which can causes pain, shortness of breath and decreased lung function.  Once the fluid is removed it may be analyzed diagnostically.

Thoracentesis can remove cancerous fluid build-up as well.  Pleurodesis may be preformed at the same time as thoracentesis.

Paracentesis is a procedure in which fluid is removed from the abdominal lining.  Pericardiocentesis, similarly, is a procedure in which fluid is extracted from the sac around the heart.

Needle Biopsies

FNA (Fine-needle aspiration) is a preferred biopsy method for areas difficult to reach, e.g. the lymph nodes located between the lungs.  This, minimally invasive, method uses a long, hollow needle attached to a syringe.  The procedure can remove a sample of up to 10,000 cells.  This is may be done as an outpatient procedure without the need for general anesthesia.

Core needle biopsies are performed when the tumor is easily accessible.  Ultrasound imaging is often used to guide the biopsy which is collected using a wider needle.  This procedure is usually done with local anesthesia.

Overall diagnostic sensitivity, even with larger samples, is around 80 percent for diagnosing mesothelioma with needle biopsies.  Therefore, needle biopsies are not as effective for diagnosing as thoracoscopic.

Tumor Removing Surgery

The attempt by surgeons to remove as much of the malignant mesothelioma cancer as possible is a surgical resection procedure.   The method allows for the most tissue analysis and often reduces the need for a second surgery if testing indicates the tumor is malignant.

A laparotomy refers to a surgical incision of the abdomen.  Thoracotomy involves surgery of the chest.

Stages of Pleural Mesothelioma

Pleural Mesothelioma Stages

A doctor will also determine the stage of mesothelioma as part of the diagnostic process, which determines the origin in the lining of the lungs and describes how far it has spread from that point. This information is significant to doctors when determining potential treatment availabilities. Standard treatment options are more commonly available to patients with stage 1 or stage 2 compared to patients with the later 3 and 4 stages.

The following are the pleural mesothelioma stages:


Within Stage 1, the mesothelioma tumor is generally in one location, and the cancerous cells have not dispersed to lymph nodes or other body organs and tissues. In general, surgical treatment may be an option for eliminating the cancerous growth.



Within Stage 2, the mesothelioma tumor is larger and has probably intruded on surrounding organs, such as the lung or even diaphragm. Lymph nodes could additionally be included. In this case, surgical reapportion might still be feasible, however much more difficult depending on the scope of the growth.


Within Stage 3, mesothelioma cancer has infested a region or perhaps location. Cancer has progressively spread throughout one side of the chest, within the chest wall, esophagus, and additional lymph nodes. Surgical treatment is typically not an option as curative therapy, however various other treatment options may be attempted. 


Within Stage 4, the mesothelioma has dispersed to numerous locations, such as various other organs and tissues throughout the body. Surgical treatment is no longer an alternative, and most treatments at this stage concentrate on minimizing discomfort and pain.