Mesothelioma Cytology and Pathology
Cytopathology reports are useful in helping diagnose mesothelioma. By looking at fluid samples under a microscope, doctors can find clues leading to a diagnosis.
Detecting Mesothelioma in Fluid Samples
Importance of Cytology
Imaging tests such as x-rays and CT scans have limitations when it comes to diagnosing mesothelioma. Cytology tests can further explain suspicious imaging tests and can even be used to determine the patient’s cell type.
Cytology reports only require a simple extraction of fluid buildup in the chest or abdomen in suspected mesothelioma patients. Patients can remain awake for the relatively quick procedure.
First line of testing
If a doctor suspects a patient may have mesothelioma, they may order a cytology report before committing to full-out tissue biopsy. These tests aren’t as accurate as tissue biopsies but can provide important clues about the diagnosis.
What is Cytology?
Mesothelioma cytology is also referred to, more accurately, as “cytopathology” because it encompasses the field of pathology—the study of the behavior of diseases. Cytopathology is the branch of pathology that studies diseases via fluid samples.
Doctors must take a fluid biopsy from a patient to conduct a cytology report. Fluid biopsies are far less invasive than tissue biopsies, and the patient remains awake for the procedure. Fluid samples are usually collected when patients start to experience symptoms of mesothelioma.
Depending on the suspected type of mesothelioma, fluid samples are collected from:
- Pleural effusions – fluid surrounding the lungs
- Ascites – fluid surrounding the abdomen
- Pericardial effusions – fluid surrounding the heart
How Fluid Samples Are Collected
Fluid samples are collected through a process known as fine needle aspiration. Doctors use a syringe with a very thin needle to take out some of the fluid in the suspected tumor area. Using fine needle aspiration, doctors don’t have to make any incisions, and the patient can stay awake for the procedure. Only a little numbing medicine is used on the skin.
How Do Doctors Test Fluid Samples?
The preparation of fluid samples can vary depending on the number of cells and amount of blood in the sample. Samples with a lower cell count may require a high-powered microscope. Blood-stained samples require special solutions to dilute the blood.
Samples are put on slides and dipped into a collection of stains, or chemical dyes. Each stain is attracted to certain elements of the cancer cell and causes a reaction that changes the cell’s color. When pathologists observe this under the microscope, they are able to assess whether the fluid sample contains, or does not contain, mesothelioma cells.
Pathologists look at the size and shape of cells and compare the samples to the likeness of mesothelioma cell types or other diseases. These tests can determine whether the patient has an epithelioid, sarcomatoid or biphasic (mixed) cell type.
Although they can be useful to diagnosis, cytology reports cannot definitively diagnosis mesothelioma. Learn more about how mesothelioma is diagnosed in our free Mesothelioma Guide.
Cytology vs. Histology
While cytology reports are less conclusive than a histology report, they are also less invasive because they don’t require a tissue biopsy.
There are, however, several benefits of cytology reports over histology reports, and doctors may prefer to take a fluid sample before an invasive tissue biopsy. Most of the benefits of a cytology has to do with the nature of the biopsies required.
- Fluid samples are easier to get
- Virtually no risk of complications
- Less costly than tissue biopsies
- Less discomfort for the patient
- Faster than tissue biopsies
Limitations of Cytology and Needle Biopsies
The first problem is that not all cases of mesothelioma have enough fluid buildup to obtain a significant sample. Doctors cannot diagnose the extent of metastasis because of this. If the sample doesn’t have enough cells present, it may not be possible to determine if the fluid sample is mesothelioma or another disease with similar traits to mesothelioma, such as adenocarcinoma.
Cytology is also limited by the process of fine needle aspiration. It can be difficult to accurately aim the needle toward the area where tumor growth is suspected. Mesothelioma tumors may be too deep in the chest or abdomen, so the needle is usually guided by a CT scan.
Doctor Experience Counts in Cytology
The experience and ability of the doctor performing the fine needle aspiration plays a large role in the accuracy of a cytology report. Get connected with a specialist experienced in mesothelioma cytology using our free Doctor Match program.