Diagnosis of Pleural Mesothelioma
How Doctors Detect and Confirm This Rare Lung Cancer
Diagnosing pleural mesothelioma can be difficult—even for experienced doctors. The disease shares symptoms with more common conditions like pneumonia, COPD, and lung infections. That’s why it’s critical for patients with a history of asbestos exposure to receive the right tests, at the right time, from providers who understand this rare cancer.
This guide explains how pleural mesothelioma is diagnosed, which tests are typically used, and why early and accurate detection matters.
Why Accurate Diagnosis Is So Important
Pleural mesothelioma is aggressive. The sooner it's found, the more options a patient has for:
Surgery
Multimodal treatment (chemo + radiation + surgery)
Clinical trials
Unfortunately, many patients are misdiagnosed or diagnosed too late—when symptoms have already progressed. That’s why knowing what to expect can help you advocate for faster, better care.
How Pleural Mesothelioma Is Diagnosed
1. Medical History and Exposure Review
Doctors begin by reviewing your health history and any known asbestos exposure. Be specific:
Jobs where asbestos was present
Household or military exposure
Products you worked with (e.g., insulation, cement, brakes)
Your exposure history can influence how aggressively your doctor pursues testing.
2. Physical Exam
A physician may check for:
Fluid in the chest cavity (pleural effusion)
Decreased breath sounds
Signs of oxygen deprivation (e.g., blue lips or fingertips)
If anything seems abnormal, you’ll be referred for imaging.
3. Imaging Tests
These scans help identify tumors, fluid buildup, and spread of disease:
Chest X-Ray: Can reveal pleural thickening or fluid, often the first test ordered.
CT Scan (Computed Tomography): Offers detailed cross-sectional images of the chest.
MRI (Magnetic Resonance Imaging): Useful for evaluating soft tissues and nearby organs.
PET Scan (Positron Emission Tomography): Highlights cancer activity and helps determine staging.
Tip: If your doctor doesn’t order a CT or PET scan and you have a history of asbestos exposure, ask for one.
4. Biopsy: The Only Way to Confirm Mesothelioma
Imaging can suggest mesothelioma, but only a biopsy can confirm it. A biopsy involves removing a small tissue sample for analysis under a microscope.
Common Biopsy Methods:
Thoracoscopy (VATS): A small camera and surgical tools are inserted into the chest to take samples.
Needle Biopsy (FNA): Uses a needle to extract tissue or fluid, often guided by CT imaging.
Thoracentesis: Removes pleural fluid for analysis—not always conclusive, but sometimes helpful.
A pathologist then analyzes the sample to confirm the diagnosis and determine the cell type (epithelioid, sarcomatoid, or biphasic), which can affect treatment decisions.
What Happens After Diagnosis?
Once mesothelioma is confirmed, your medical team will conduct staging tests to determine how far the cancer has spread. This helps guide treatment decisions.
Stage 1 or 2: Cancer is localized; surgery may be an option.
Stage 3 or 4: Disease has spread; treatment focuses on slowing progression and improving quality of life.
Learn more about Staging of Pleural Mesothelioma →
Concerned About a Delayed Diagnosis?
If you were exposed to asbestos and are experiencing symptoms, but your concerns have been dismissed or misdiagnosed, it’s okay to seek a second opinion. Pleural mesothelioma is rare and often overlooked—especially in general practice settings.
Free Help Getting Diagnosed
We assist patients and families by:
Reviewing exposure history
Helping you get the right imaging and testing
Connecting you with mesothelioma specialists
📞 Call 833-4-ASBESTOS
Or contact us online to schedule a free asbestos health screening.