Surgical biopsies are considered to be “open” procedures and as a result, more invasive than needle biopsies. This type of biopsy is most often performed when the results from a needle biopsy or other less invasive diagnostic procedures are inconclusive or if there is evidence that it would not be safe to perform those types of tests.
There are times when the less invasive biopsy procedures are contraindicated. For example, when the pockets of fluid are in “hard to reach” areas as opposed to being free flowing or if CT Scans indicate that it would not be safe to perform those procedures open surgical biopsy would be considered. The following are the most common types of surgical biopsies that are performed to aid in mesothelioma diagnosis:
A thoracotomy is considered an open surgery. In performing this operation, a surgical incision is made in the chest wall to allow the surgeon to examine the area around the lungs and to obtain a tissue sample for further testing if it appears that abnormalities are present. Thoracotomy aids in the diagnosis of pleural mesothelioma.
A thoracoscopy will often be recommended by doctors when a patient is exhibiting mesothelioma symptoms, has a history of asbestos exposure and test results from other less invasive diagnostic procedures such as a closed pleural biopsy show clear cytology.
Laparotomy surgery is similar to thoracotomy surgery except that the incision is made in the abdomen. This allows the surgeon to examine the fluid and tissue in the area of the peritoneum and if abnormalities are detected, to obtain a biopsy sample for further testing and diagnosis of peritoneal mesothelioma.
Laparoscopy is a video assisted procedure that allows surgeons to examine organs in the abdominal region and perform a biopsy of abnormal tissue to aid in the diagnosis of peritoneal mesothelioma.
Mediastinoscopy is often performed to help doctors diagnose and stage mesothelioma cancer. The results of the procedure then help them develop an effective treatment plan. For example, if lymph nodes test positive for cancer, surgical intervention would not be a recommended treatment option for a patient because the disease would have progressed to at least stage 3.
Diagnosing mesothelioma is not always easy. Fluid buildup alone in the chest, abdomen or heart regions is not enough to confirm a diagnosis. Tissue samples obtained from biopsy procedures do not always yield conclusive results because mesothelioma cancer cells often resemble other types of cancer. For this reason, specialized stains known as immunos are often used in the examination of the fluid and tissue samples to better distinguish between cancerous and non-cancerous mesothelioma cells.
JE Heffner, Medical University of South Carolina,. "Pleural Fluid Analysis, Thoracentesis, Biopsy, and Chest Tube” , 2006
Harvey I. Pass, John A. Dingell, Susan Vento: 100 Questions & Answers About Mesothelioma. (Jones and Bartlett Publishers, Inc., 2005)
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