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Needle biopsies for diagnosing mesothelioma

After a thorough physical exam and one or more scans, your doctor will have a better sense of what’s wrong. Without a biopsy, however, your doctor cannot conclusively diagnose malignant mesothelioma.

During a biopsy, a doctor obtains tissue, cell, or fluid samples which will be analyzed by a pathologist, a doctor trained to detect cancer by studying cells and tissue under a microscope, or by a cytologist, a specially-trained doctor who analyzes cells from fluid under a microscope.

Biopsies sound frightening. But the good news is that a biopsy does not always mean invasive surgery. Needle biopsies are a minally invasive way to get the needed tissue samples.

If your doctor suspects cancer, the first step is usually a biopsy which allows your doctor to obtain samples of tissue and fluid surrounding your lung and abdomen without actually cutting into the chest or the abdomen. Instead, a surgeon, a pulmonologist (lung doctor), or an oncologist (cancer specialist) uses a needle to acquire tissue or fluid which will be examined by a pathologist and/or cytologist. A local anesthetic is used to numb the area where the needle will be inserted. This is also called a needle biopsy.

Three types of needle biopsies are available to diagnose mesothelioma cancer:

Pleural biopsy

This test is performed to diagnose pleural mesothelioma. A doctor, usually a pulmonologist, uses a special needle to obtain a sample of the pleura, the thin layer of tissue covering the lungs and lining the wall of the chest cavity. A pathologist will then study the tissue samples under a microscope to determine if you have pleural mesothelioma cancer.


A thoracentesis is often performed right after the pleural biopsy. The doctor inserts a needle or flexible tube (also called a catheter) between the ribs to draw some of the fluid out.

A pathologist and/or cytologist will then study the cells in the fluid. Normally, the fluid is stained with a substance called an immunohistochemistry stain (sometimes referred to as an immuno stain). This stain is important because it makes the diagnosis from fluid far more accurate.


To diagnose peritoneal mesothelioma, the surgeon or oncologist performs a paracentesis. The doctor inserts a thin needle or tube to draw fluid from the peritoneal cavity (the space in your abdomen that contains the stomach, intestines and liver). The cells in the fluid are then stained and analyzed under a microscope by a pathologist or cytologist in order to determine if you have peritoneal mesothelioma.

After these tests, you will have another x-ray to be sure there were no complications from the biopsies, such as air in the chest. X-rays also help determine if a sufficient amount of the fluid, which can cause discomfort or pain, has been removed.

If possible, it is a good idea to have these tests performed at a leading cancer treatment hospital where you will work with a team of specialists including surgeons, oncologists, pathologists, cytologists and others who diagnose and treat cancer every day. If the diagnosis is mesothelioma, it is very important to be treated by those who specialize in this rare disease.

It is also important to determine your legal rights. You should contact Williams Hart to see if an asbestos lawsuit is appropriate in your case. Our mesothelioma law firm has helped thousands of clients suffering from mesothelioma and their families. Our mesothelioma lawyers and other experts know how to help you go back decades to try to find the source of asbestos exposure that may have caused the disease. They can also help determine if the liable parties are still around, and determine who may be responsible for your injuries.

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