Mesothelioma: Symptoms and Diagnosis

The initial symptoms associated with mesothelioma are usually pain in the back, chest or abdomen as well as fatigue and loss of weight. This is usually followed by an unexplained and sudden shortness of breath caused by a buildup of fluid (called a pleural effusion) between the lining of the lung and the chest cavity. A chest x-ray will usually look like it has a haziness on one or more sides of the chest or an entire lung may be hidden from view. Usually, draining the fluid buildup (a procedure called thoracentesis) relieves the shortness of breath. In a few weeks, the fluid may build up again, requiring additional draining.

Malignant mesothelioma is often difficult to diagnose. A definitive diagnosis can only be made after a biopsy is performed to obtain a tissue sample. Sometimes a needle biopsy is sufficient but often surgery must be performed and an open biopsy conducted to obtain the appropriate tissue sample.

Because malignant mesothelioma is a rare disease, many hospitals and physicians do not make the appropriate diagnosis. Malignant mesothelioma often has the appearance of an adenocarcinoma (a different type of cancer) and is thus sometimes misdiagnosed. Special stains must be performed (immunohistochemistry) or the biopsy must be viewed with an electron microscope in order to make a definitive diagnosis. In rare instances a correct diagnosis can only be made after an autopsy.

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