Tests for pleural mesothelioma

Pleural mesothelioma often starts as tiny lumps (nodules) in the pleura. These will not show up on x-rays or scans until they are quite large.

If fluid has developed between the two layers of the pleura (pleural effusion), this can usually be seen easily on a chest x-ray at an earlier stage. So you may need to have a number of different tests before your doctors can make an accurate diagnosis. Your doctor or nurse will tell you about the most suitable tests for you and what they involve.

Chest x-ray

A chest x-ray checks your lungs for anything that looks abnormal, such as thickening of the pleura or fluid around the lungs. These symptoms can be caused by conditions other than mesothelioma.

CT (computerised tomography) scan

A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body.

Drainage of fluid from the pleura (pleural aspiration)

Mesothelioma cells can cause fluid to develop around the lung. This is called a pleural effusion. Your specialist doctor may take a sample of this fluid to send to the laboratory, to see if it contains mesothelioma cells. This is called a pleural aspiration. Draining the fluid may also help with your breathing.

Pleural biopsy

During a biopsy, a small piece of tissue is removed so that it can be looked at under a microscope. This can help confirm a diagnosis. For mesothelioma, doctors usually take a piece of tissue from the thickened pleura. This is called a pleural biopsy. This is more likely to confirm the diagnosis than a sample of fluid.

Sometimes, even after taking a biopsy, the doctors may still not be sure of the diagnosis. This is because pleural mesothelioma can be difficult to tell apart from some other cancers and illnesses. If this happens, the samples may be sent to specialist laboratories to confirm the diagnosis. Sometimes you may need to have a test repeated, or you may be referred to another hospital for a second opinion.

Tests for peritoneal mesothelioma

You may have a number of different tests to help diagnose peritoneal mesothelioma.

Abdominal x-ray

An abdominal x-ray checks for anything abnormal in your tummy area (abdomen).

CT (computerised tomography) scan

A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body.

MRI (magnetic resonance imaging) scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body.

Drainage of fluid from the abdomen (peritoneal aspiration)

Mesothelioma cells can cause fluid to collect in the abdomen. This is called ascites. Your doctor may take a sample of this fluid to send to the laboratory, to see if it contains mesothelioma cells. This is called a peritoneal aspiration.

Peritoneal biopsy

During a biopsy, a small piece of tissue is removed so that it can be looked at under a microscope. This can help confirm a diagnosis. Your doctor may suggest a biopsy of the peritoneum (lining that covers the organs in the tummy) to help diagnose peritoneal mesothelioma. This is called a peritoneal biopsy.

Sometimes, even after taking a biopsy, the doctors may still not be sure of the diagnosis. This is because peritoneal mesothelioma can be difficult to tell apart from some other cancers and illnesses. If this happens, the samples may be sent to specialist laboratories to confirm the diagnosis. Sometimes you may need to have a test repeated, or you may be referred to another hospital for a second opinion.