If a large amount of fluid is present, abnormal cells can be found by cytology, by aspirating the fluid with a syringe. In cases of pleural fluid it is carried out by a pleural tap or chest drain, in peritoneal fluid, with an ascitic drain or paracentesis, and in a pericardial effusion with pericardiocentesis. Although, the absence of malignant mesothelioma cells in cytology does not totally rule out mesothelioma cancers, it even makes it more improbable, particularly when there can be an alternate diagnosis, such as tuberculosis, heart failure.
When cytology is comfirmed or a plaque is considered as suspicious, a biopsy is then further needed to confirm a mesothelioma diagnosis. A mesothelioma doctor extracts a specimen of tissue for investigation under a microscope by a pathologist. A biopsy can be carried out in various ways, based on the location of the abnormal area. If the mesothelioma cancers is located in the chest, the mesothelioma doctor can carry out a thoracoscopy. Using this technique, the mesothelioma doctor incises a little cut through the chest wall and passes a thin, tube known as a thoracoscope into the chest through two ribs. The thoracoscopy precedure helps the mesothelioma doctor to be able to view the inside of the chest and extract tissue specimens.
Cytology examines the pleural fluid for malignant cells. Some medical practitioners regards this option as limited in mesothelioma diagnosis, because uncomfirmatory examination account for about 85% of all fluid test. Even when there is a comfirmatory fluid report, most doctors will still carry out a confirmatory tissue biopsy in as much as does not negatively affect the patient's well being.
If it is mesothelioma cancers of the abdomen, the mesothelioma doctor can carry out a laparoscopy. To obtain tissue for examination, the doctor also incises a little cut in the abdomen and passes a specified instrument into the cavity of the abdominen.