Diagnosing Mesothelioma

On visiting your GP you will be examined and he or she may arrange for blood tests and/or x-rays. You may then be referred to a hospital for further tests and specialist advice and treatment.

At the hospital your medical history will be reviewed and a physical examination carried out. Questions regarding your occupational history may be asked about possible exposure to asbestos in your past, maybe during jobs or at your place of work.

Pleural mesothelioma often starts as tiny lumps (nodules) in the pleura, which sometimes do not show up on x-rays or scans until they become larger, so you may require a number of different tests in order to diagnose mesothelioma.

Chest X-ray

A physical examination is carried out including various lung function tests and an X-ray checks for abnormalities in your lungs, they may reveal thickening of the pleura or fluid around the lungs, commonly seen after asbestos exposure. Unfortunately this increases the of suspicion mesothelioma .

CT (Computerised Tomography) Scan or MRI Scan

A CT scan is a series of x-rays of three dimensional detailed pictures of areas inside the body created by x-rays linked to computers.

You'll be asked not to eat or drink for at least four hours before your scan. The scan is usually completely painless and takes about 10 to 30 minutes. CT scans do use a small amount of radiation but this is usually harmless and will not affect or harm anyone you are in contact with.

You may be given an injection or a drink of a dye which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes, and if you are allergic to iodine or have asthma you could have a more serious reaction so be sure to inform your doctor beforehand. This test does not usually mean a stay in hospital

PET Scan (Positron Emission Tomography)

This is a newer type of scanner found in specialist centres, often a little further afield than the normal CT scanners.

If an x-ray or CT scan does not give a definite result, sometimes a PET scan may be suggested after discussions with your doctor as to whether it would prove useful in your case. Low dose radioactive glucose (sugar) is used in PET scans in order to measure the activity of cells in different parts of the body. The substance is usually injected into a vein in your arm and a scan is then taken a couple of hours later.

Because cancer cells are usually more active than other tissue, these then show up more clearly on the scan results.

Pleural Aspiration

A Pleural effusion is when Mesothelioma cells irritate the pleura and causes a pocket of fluid to develop. Your doctor may take a sample of the fluid under a local anaesthetic to deaden the area, and then a needle is inserted into the fluid through the skin and is removed for analysis.

Peritoneal Aspiration

Mesothelioma cells in the peritoneum cause a build up of fluid in the abdomen. The procedure that will be carried out is similar to a pleural aspiration.


If a biopsy is required a tissue sample will be taken from the thickened pleura or peritoneum. Firstly a local anaesthetic is used to numb the area in question after which a special needle is used that passes through the skin and is able to remove a sample of the tumor which can then be analyzed. Biopsies can be uncomfortable but should not be painful; any pain can usually be dealt with pain killers.

Biopsies have to be studied in a laboratory in order that a diagnosis of mesothelioma may be confirmed or rejected. Mesothelioma is very difficult to tell apart from other illnesses so even a biopsy is not always certain of getting a result. If this is the case then sometimes the tests may have to be repeated, the samples may be sent for further diagnosis in a different laboratory, or sent for a second opinion to another hospital.

Unfortunately it could take several days for all the results of your tests to be completed. This might be a good time to take advantage of cancer support specialists in order that you can discuss and talk about your worries and possible procedures that may yet have to happen.

A Pleural Biopsy can be taken in two different ways:


A general or local anaesthetic is used in order that a small cut can be made in the chest wall, then a thin flexible tube with a light at the end can be inserted in the chest so that the doctor can take a biopsy of the pleura. A video camera can also be used to perform procedures like pleurodesis (video assisted thoracoscopy).

CT or Ultrasound guided biopsy

A CT scanner or ultrasound is used to accurately position the needle in order to remove a sample of the tumor which can then be analyzed.

A Peritoneal Biopsy can be carried out by:


After a general or local anaesthetic a small cut is made in the abdomen and a tube is inserted with a light at the end. This allows the doctor to take a small biopsy of the peritoneum.

CT scan or Ultrasound guided biopsy

The ultra sound or CT scan allows the doctor to pinpoint the position that the needle needs to be inserted in order to accurately locate the tumour.

Other tests can be carried out to check to see if the mesothelioma has spread:


This is a similar procedure to a Thoracoscopy. Under a general anaesthetic a cut is made in the base of the neck so that lymph nodes in the space between the lungs can be examined and samples taken if necessary.

Endobronchial ultrasound scan (EBUS)

This test is used if your scans show swelling of the lymph nodes around the lung. After being given a sedative, a thin flexible tube (bronchoscope) is inserted in the mouth and down into the windpipe.

An ultrasound probe is then attached to the bronchoscope whereby the doctor can see inside the lungs to ascertain the size of the tumour and if any nearby lymph nodes are involved. Biopsy samples can be taken by passing a needle down the bronchoscope at this point.