In many cases, diagnosis is further complicated by the fact that the pathologist has only a very small amount of biopsied tissue available for histological evaluation. This type of assessment uses a microscope evaluation of the tissue to determine if it is cancerous. If it is, then tests are performed to determine the type of cancer it is.This problem is being compensated for through the recent use of video-assisted thoracoscopy (VAT) malignant mesothelioma biopsies.
This is a relatively new type of surgery that allows the doctor to see inside the chest cavity with only very small incisions. It also makes it possible to remove a mass that is close to the outer edges of the lung without the type of invasive surgery that was performed in the past. VAT has significantly increased the size of pleural biopsies and the choice of sampling sites, resulting in enough of the right kind of tissue to make an accurate diagnosis.The appearance of malignant mesothelioma cells can vary greatly within the same patient when examined under the microscope. In addition, a number of other tumors, either beginning within the thorax, or spreading from sites outside the thorax can mimic malignant mesothelioma. There are also a number of non-cancerous conditions that affect the pleura or liquid-filled sac between the lungs and chest wall that are similar in appearance to pleural malignancy.
However, the recent widespread use of immunohistochemistry has substantially improved the accuracy of diagnosis. This is a complex pathological test that stains cancer cells with fluorescent dyes or enzymes in order to reveal specific proteins that are biomarkers for these types malignant mesothelioma of cells.
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