Mesothelioma Biopsy

What Is a Mesothelioma Biopsy?

A biopsy is when a physician collects a sample from the body for analysis. The sample may be drawn from fluid or directly from tissue depending on the specific case and affected area.

The collected sample is then sent to a pathologist (a specialist who studies body tissues and organs), who will examine it under a microscope.

The pathologist will look for specific chemical markers as well as cancer cells. If a pathologist finds possibly cancerous cells, they will run further tests to see if the patient has mesothelioma.

The only definitive way to diagnose mesothelioma is with a biopsy. However, doctors can perform additional tests, including bloodwork and imaging scans, to help confirm a diagnosis.

Learn more about mesothelioma biopsies and the next steps to take after diagnosis in our Free Mesothelioma Guide — shipped overnight to your door.

What Is Studied in a Mesothelioma Biopsy?

Pathologists typically study either fluid or tissue samples as part of a mesothelioma biopsy.

Tissue Samples

Doctors will usually try to collect tissue samples directly from a possibly cancerous tumor or growth. This is the most common way mesothelioma biopsy samples are taken.

“Often, people talk about doing a needle biopsy or taking the fluid, and sometimes the [mesothelioma] diagnosis can be established like that. Often it requires an actual tissue biopsy.”
—Dr. Joseph Friedberg, mesothelioma specialist

Most mesothelioma tissue biopsy samples usually come from the covering of the lungs (pleura) or from the abdomen lining (peritoneum) based on other symptoms and information gathered prior to the biopsy.

Fluid Samples

If the patient experiences fluid buildup as one of their symptoms, then the doctor may sometimes choose to test the fluid for mesothelioma cells.

In most cases, the fluid will either be pulled from the chest (thoracentesis), the abdomen (paracentesis), or the fluid sac surrounding the heart (pericardiocentesis).

However, even if the fluid sample is free of cancer cells, it does not mean the patient is cancer-free. It could simply mean that the sample did not contain any cancer cells. This makes tissue biopsies slightly more reliable when making a mesothelioma diagnosis.

What Type of Biopsy Is Done For Mesothelioma?

There are mainly 2 types of biopsies: non-surgical (needle) biopsies and surgical biopsies. It is important that the doctor performs the most relevant type of biopsy for the patient’s specific case in order to ensure an accurate diagnosis.

The type of biopsy used depends on the:

• Condition of the tumor/tissue
• Location of the tumor and/or where symptoms are occurring
• Patient’s overall health and well-being

As with most medical procedures, each option has its pros and cons.

Needle Biopsies

A needle biopsy is a less invasive biopsy method. It requires only local anesthetic, needs no incision, and can be done as an outpatient procedure, meaning you will not have to stay overnight in a hospital.

There are a few different types of needle biopsies.

CT-Guided Core Biopsy

This is the most commonly recommended needle biopsy. A needle with a special tip meant for cutting tissue is inserted into the lining of the abdomen or lungs.

A CT scan is used to help guide the way and a sample of tissue is removed for analysis. However, it can sometimes be hard to get a large enough sample for a definitive mesothelioma diagnosis.

Fluid Extraction Biopsy

With this type of needle biopsy, a long, hollow needle is inserted into the body to extract a sample of the fluid. As mentioned above, the cells in the fluid are analyzed to determine if they are cancerous, and if so, what type.

While being an extremely fast and relatively painless procedure, there is a risk that the sample is not sufficient enough. If this happens, the findings might be inconclusive, and another biopsy must be conducted.

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Surgical Mesothelioma Biopsies

The more invasive but reliable form of biopsy is a surgical biopsy. There are two main types of surgical biopsies.

Endoscopic Biopsies

This is the most commonly used form of surgical biopsy. An endoscope (a thin tube with a small camera and light on the end) is inserted after giving the patient anesthesia and making small incisions in their body. At the end of the scope is a tool used to gather tissue samples.

There are two types of surgical endoscopic biopsies:

• Laparoscopy: Small incisions are made in the abdomen, and a laparoscope is inserted to collect tissue samples. This test can help diagnose peritoneal mesothelioma.
• Thoracoscopy: If the area of concern is the lungs and chest, the procedure is called a mesothelioma thoracoscopic biopsy or thoracoscopy. Small incisions are made in the patient’s chest for a thoracoscope to fit through. The biopsy samples are removed from the lung lining to check if the patient has pleural mesothelioma.

While endoscopic biopsies are more invasive and therefore carry more potential risks than needle biopsies, there are numerous benefits. An endoscopic biopsy allows the doctor an opportunity to see where the cancer is and if it has begun to spread.

It also allows doctors to remove tissue and fluid (if any), which can provide physical relief for the patient and more samples to analyze.

Open Surgical Biopsies

Sometimes a physician deems an open surgical biopsy necessary for an accurate diagnosis. This type of biopsy is the most invasive and has a longer recovery period.

It involves a larger incision in either the chest (thoracotomy) or abdomen (laparotomy) and allows the surgeon to remove a bigger tissue sample. It also allows for the removal of the entire tumor at times.

What to Expect During a Mesothelioma Biopsy

Knowing what to expect during a biopsy can help put you a little more at ease, even if you possibly have mesothelioma or another cancer.

What to expect will vary depending on what type of biopsy you have been prescribed.

Needle Biopsies

• A local anesthetic will be applied to the area where the needle will be inserted. You will be required to lie very still for approximately 30 minutes.
• You may have the procedure performed at your doctor’s office or in the hospital as an outpatient procedure.
• Following the biopsy, you’ll need to stay in observation for a couple of hours to ensure there are no complications. For fluid extraction, the time required is even less.
• On rare occasions, bleeding or a collapsed lung can occur, so doctors will keep you in observation until they are sure you are not dealing with either complication. After observation, you will be free to go and should feel back to normal.

Endoscopic Biopsies

• You will undergo general anesthesia and need to stay in the hospital.
• You will have one or more small incisions that must be tended afterward. You might feel some discomfort from them, and if so, your doctor can give you pain medication.
• During the days following your surgery, it is important to notify the doctor if you have any breathing difficulties or feel unwell.

Open Surgical Biopsies

• Be prepared for a longer recovery time as well as more intensive after-care.
• Your doctor can notify you of how long you’ll need to stay in the hospital and what to expect after this biopsy.

We can help you learn more about what to expect during a mesothelioma biopsy and beyond. Get started right now by requesting your copy of our Free Mesothelioma Guide.

Reviewing Mesothelioma Biopsy Results

Once the pathologist receives a biopsy sample, they will examine the cells to determine their type.

The pathologist will also be able to determine what mesothelioma cell type a patient has based on the appearance of the cells as part of their work. This is important because cell type significantly affects a patient’s overall prognosis (health outlook) and treatment options.

Getting a Second Opinion on Biopsy Results

A mesothelioma biopsy can be life-changing: Your doctor will determine if you have this cancer or not, and from there, you can start treatments that can hopefully help you live longer.

That said, seeking a second opinion on your biopsy is always a good idea. Through a second opinion, another doctor can review your mesothelioma biopsy findings and confirm or refute your initial diagnosis.

A second opinion is helpful because:

• You can avoid a misdiagnosis: Mesothelioma is often misdiagnosed at first. The cells of this cancer can look like those of other cancers on a biopsy test. A second opinion can determine if you were accurately diagnosed.
• You could get better news: When reviewing your biopsy results, another doctor could determine that you were misdiagnosed with a more treatable cancer. Or, they may believe you can undergo more treatments than initially thought.
• You’ll get peace of mind: Even if your diagnosis doesn’t change from a second opinion, you’ll be able to rest easier knowing that your initial mesothelioma biopsy findings were accurate.

The best choice you could make for your health moving forward is to find a specialist who can help you get a biopsy and offer treatments after a diagnosis. Use our Free Mesothelioma Doctor Match to find a specialist near you today.