Written By: David Statman
Mesothelioma Pleural Fluid Analysis
Mesothelioma pleural fluid analysis is another term for a pleural mesothelioma fluid biopsy test, also called cytology. A pleural fluid analysis can be used in the process of obtaining a pleural mesothelioma diagnosis. However, using a fluid analysis is less conclusive than using a tissue biopsy.
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Karen Ritter, RN BSN
Registered Nurse
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Everything You Need to Know About Pleural Mesothelioma
What Is Pleural Fluid?
Pleural fluid is the fluid in between the layers of the pleura, also called the pleural cavity. The pleural space between the lungs and chest serves as a buffer for the lungs to expand and contract as needed.
The pleura is where pleural mesothelioma forms. Pleural mesothelioma is a cancer of the lining of the lungs. The pleura contains mesothelial cells, which can turn cancerous due to genetic mutations caused by asbestos fibers. These fibers can get stuck in the pleural tissue linings.
Fluid Within the Pleural Space
How a Pleural Fluid Analysis is Performed
Pleural fluid can contain mesothelial cells, which if cancerous can help doctors find evidence of pleural mesothelioma. There are not as many mesothelial cells in pleural fluid as there are in pleural tissue. Doctors can still collect a sample of the pleural fluid for analysis. Collecting pleural fluid with mesothelial cells is how to do a pleural fluid analysis.
Some people ask whether mesothelial cells are normal in pleural fluid. This is normal, mesothelial cells cover the surface of the lungs, the inside of the chest wall and around the heart. Between the pleura and chest wall is fluid (pleural fluid), so it’s common for mesothelial cells to be in this fluid.
What Are Pleural Effusions?
Pleural effusions are one of the symptoms of pleural mesothelioma. A pleural effusion is a buildup of fluid between the two pleural linings. Pleural effusion occurs due to sharp asbestos fibers in the pleural cavity.
Irritation and scar tissue developing from asbestos fibers is the cause of pleural effusion. This irritation and scar tissue causes a disruption in the normal transfer of fluid across the mesothelial cells of the pleura, which forms pockets of fluid called pleural effusions.
The signs of a pleural effusion are a cough, chest pain and shortness of breath, some of which is due to the lungs having less of a buffer space to expand against the chest. There are ways to treat pleural effusions and it’s an option for patients with pleural mesothelioma.
Mesothelioma Pleural Fluid Analysis for Diagnosing Pleural Mesothelioma
A mesothelioma pleural fluid analysis can be used in the diagnostic process for malignant mesothelioma. However, using a fluid analysis is less definitive and effective than a tissue biopsy in diagnosing mesothelioma.
According to one study, a fluid biopsy accurately diagnosed 26% of mesothelioma cases. By comparison, tissue biopsies were accurate 98% of the time.
Fluid Biopsy Accuracy
Tissue Biopsy Accuracy
Thoracentesis for Pleural Mesothelioma
The main type of fluid biopsy for malignant pleural mesothelioma is a thoracentesis. In this surgical procedure, doctors will pass a needle between the ribs into the pleural space followed by a thin catheter tube to collect pleural fluid.
Thoracentesis is also a pain-relief treatment option for mesothelioma patients with severe pleural effusions who need to drain fluid for comfort and easier breathing.
Sources & Author
- Pleural Effusion. Penn Medicine. Retrieved from: https://www.pennmedicine.org/conditions/pleural-effusion. Accessed: 02/09/2023.
- Tests for Malignant Mesothelioma. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/how-diagnosed.html. Accessed: 05/05/2020.
- Types of biopsies used to look for cancer. American Cancer Society. Retrieved from: https://www.cancer.org/treatment/understanding-your-diagnosis/tests/testing-biopsy-and-cytology-specimens-for-cancer/biopsy-types.html. Accessed: 05/05/2020.
AI Summary of Mesothelioma Pleural Fluid Analysis
Mesothelioma pleural fluid analysis, also known as a pleural biopsy, is a medical test used to examine the fluid found between the layers of the pleura, which are thin membranes lining the lungs and chest cavity. This fluid, called pleural fluid, naturally surrounds the lungs to aid in their movement and expansion. However, in cases of pleural mesothelioma, abnormal cells from the cancer can be present in this fluid, providing valuable information for diagnosis. While a fluid analysis can offer helpful clues, it is generally less conclusive than a tissue biopsy, which involves examining a small piece of affected tissue directly from the pleura.
The process of analyzing pleural fluid typically involves a procedure called thoracentesis. During this procedure, a doctor inserts a thin needle between the ribs into the pleural space to carefully withdraw a sample of the fluid. This minimally invasive method can not only help in diagnosing mesothelioma but also provide relief for patients experiencing significant fluid buildup that might cause discomfort or breathing difficulties. It is important to note that mesothelial cells, which line the pleura, are usually present in pleural fluid, and their appearance or abnormal changes can assist clinicians in identifying signs of mesothelioma. Although the presence of these cells can be normal, their detailed examination under a microscope can reveal cancerous changes that suggest mesothelioma.
Pleural effusions, which are common in pleural mesothelioma, refer to the buildup of excess fluid in the pleural space. This accumulation results from irritation and scarring caused by asbestos fibers lodged in the pleura, disrupting the normal flow and absorption of fluid. Symptoms associated with pleural effusions include a persistent cough, chest pain, and shortness of breath, as the excess fluid limits lung expansion. Managing pleural effusions is an important aspect of patient's care, as draining the fluid can improve breathing and reduce discomfort. While fluid analysis alone cannot definitively diagnose mesothelioma, it provides important clues and helps guide further testing, including tissue biopsies, which remain the most accurate method for confirming this disease. Overall, pleural fluid analysis is one part of a comprehensive approach to diagnosing and understanding pleural mesothelioma, offering patients and doctors additional information during the evaluation process.