Mesothelioma

Mesothelioma Biopsy

A biopsy describes a medical procedure that involves removing cells or tissues for closer examination and is commonly used to detect whether mesothelioma is present in the body. Microscopic examination of tissues removed by a pathologist or chemical analysis typically follows the tissue removal to examine the tissue further. Biopsies are generally conducted to help determine the cause of a disease when there is uncertainty in terms of the extent and nature of the illness. For instance, tumors identified from radiographic scans are frequently biopsied to determine whether they are benign or malignant.

Physicians perform several types of biopsies on a routine basis. A bone marrow biopsy samples a small amount of marrow, usually from the hip, to diagnose illnesses such as leukemia. A colposcopy, or cervical biopsy, is useful to determine the cause of an abnormal pap smear. An endoscopic biopsy samples internal organs through the mouth, anus, or skin incision. Excisional biopsies remove entire lesions for analysis such as for the examination of breast lumps. Small lumps in muscle or other connective tissue may be sampled by an incisional biopsy that requires only a small sample. Conditions that affect the liver or thyroid can be biopsied by a slender hypodermic needle.

It is normal to experience at least some pain around the biopsy site and can be controlled by prescribed pain-relieving medication. Biopsy specimens once obtained are affixed in a preservative, set in wax, and thinly sliced by the examining pathologist. Different dyes are applied to the sliced specimen to highlight any abnormalities. Once results are conclusive, a diagnosis and treatment plan will typically follow.

Types of Biopsies Used in a Mesothelioma Diagnosis

Once mesothelioma is suspected (generally as a result of an imaging test or x-ray), tissue and fluid samples must be obtained for a solid diagnosis. Although a mesothelioma diagnosis can be difficult, an important tool is the surgical biopsy. There are three categories of surgical biopsies used to diagnose mesothelioma: incisional biopsy, excisional biopsy, and needle-aspiration biopsy. It is important to note however, that a biopsy is not the first step in obtaining a mesothelioma diagnosis. By the time a biopsy is warranted, the patient will have undergone a thorough assessment of their symptoms, health history and occupational history, particularly if asbestos exposure is relevant. Other diagnostic tests such as a chest x-ray and blood tests will generally dictate the necessity of obtaining a biopsy.

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All biopsies involve the removal of tissue. An incisional biopsy, also known as a core biopsy, is the least invasive and involves the removal of a relatively small amount of tissue. However, pleural, peritoneal, and pericardial mesothelioma cases tend to harbor cancer cells that are not easily accessed with incisional biopsies. This is due to the often-disseminated nature of the target cells. These cases lend themselves to the excisional biopsy, which may involve the removal of entire areas of tissue containing mesothelioma cells. Excisional biopsies may entail a more complicated surgery involving sensitive linings of vital organs. The needle-aspiration biopsy involves the insertion of a relatively long, hollow needle to obtain a desired cancer cell sample. Biopsies to diagnose mesothelioma may require general, local, or no anesthesia depending on the procedure.

After the biopsy is complete, the tissue will be examined by a pathologist. Pathologists specialize in disease diagnosis and generally examine cells under a microscope to search for abnormal cell growth. Oncologists will also want to determine if mesothelioma has spread to other parts of the body and biopsies can help reveal this information. When tumors are removed and a pathologist examines them, the doctor will determine if "negative margins" or "positive margins" are present. Negative margins indicate that cancer has likely not spread whereas positive margins may indicate that cancer is present is other parts of the body.

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