A team of researchers at the Tokyo Metropolitan Cancer and Infectious Diseases Center at Komagome Hospital in Tokyo, Japan published a case study that could herald a new breakthrough in diagnosing mesothelioma.
The researchers detailed the case of a 65-year-old man showing extensive pleural adhesions who was diagnosed with stage 3 pleural mesothelioma through the use of thoracoscopy with local anesthesia, a process that is generally not used for a patient presenting such symptoms.
The key to the process was the use of a technique called cryobiopsy, which has allowed specialists to obtain larger tissue samples through use of a probe that freezes lung tissue. It’s a novel, minimally invasive approach that proved effective in this case, and could potentially be an option for similar cases.
“(Local anesthesia thoracoscopy) using cryobiopsy can be feasible for patients with severe adhesions if safe access to the pleural space is achievable and sufficient tissue of target lesions can be obtained within that area,” according to the study’s abstract.
More About the Mesothelioma Case Study
The patient, a 65-year-old construction worker with a history of occupational asbestos exposure, presented at Komagome Hospital with severe weight loss and chest pain, suffering from ventilatory impairment and needing a cane to walk.
A CT scan immediately revealed a small amount of pleural effusion – buildup of fluid in the lining of the lungs – and areas of thickened tissue, which led doctors to suspect stage 3 pleural mesothelioma. However, the patient’s pleural adhesions – or bands of scar tissue between the lung and inner chest wall – were serious enough that some of the less-invasive biopsy techniques were not recommended.
However, the patient’s overall poor health led the team to believe that putting him under general anesthesia could lead to a negative outcome. This led them instead to attempt a thoracoscopy with local anesthesia, using the cryobiopsy technique.
A thoracoscopy is a camera-assisted surgical procedure that uses a tiny camera to view the chest cavity for tumors and disease. Coupled with the cryobiopsy, this allowed them to obtain larger tissue samples in a less invasive and potentially damaging way, leading to a positive diagnosis of stage 3 pleural mesothelioma.
What This Means for Mesothelioma Diagnosis
In their case study, the researchers expounded on the reasons why this technique was successful, and how it may be used to diagnose pleural mesothelioma in the future. For one, the patient’s relatively small amount of pleural effusion meant that the pleura was much easier to reach, allowing for direct access to the tissue within.
In addition, pre-surgery scans were able to pin down the precise location of a target lesion, which allowed them to make an incision and start the procedure directly over it. In other patients with more severe pleural effusion or less accessible lesions, this type of procedure may not be feasible.
However, the cryobiopsy’s ability to safely gather larger amounts of tissue could prove to be a valuable tool in diagnosing potential pleural mesothelioma patients who have large amounts of pleural adhesions but may not do well with general anesthesia.
Especially for patients who are in poorer health when they present for treatment, the use of a thoracoscopy with local anesthesia and cryobiopsy could be an additional, less invasive tool in diagnosing mesothelioma.
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