Mesothelioma Pathology

This report is based on data compiled from either a histology test or a cytology test (or both). Histology and cytology are separate medical terms that make up pathology testing and reports. Which one your pathologist performs depends on whether you undergo a tissue biopsy or get fluid samples removed.

Cytology is the study of cell structure and cells’ functions. This term can be interchangeable with cytopathology, which refers to the examination of diseases at the cellular level.

In the case of studying mesothelioma, pathologists analyze fluid samples to learn more about the potential presence of malignant cells. Doctors use a needle to extract a sample of the fluid that has built up in either the pleura or the peritoneum. Pathologists then stain it to see if there are malignant cells that react to the stain.

Mesothelioma cytology involves a less-invasive diagnostic procedure than a tissue biopsy. Doctors will not need to make a large incision or use a thick needle to remove fluid.

However, making a definitive diagnosis with fluid samples is challenging. There are often not enough malignant cells in the sample to determine if a patient has mesothelioma. Pathologists also have difficulty analyzing the cells that are provided in the sample.

“It’s harder to examine the architecture of the individual cells suspended in the fluid,” said Dr. Elliot Wakeam, a thoracic oncologist at Michigan Medicine.

For these reasons, many mesothelioma doctors and pathologists prefer tissue samples and histology for the mesothelioma pathology process.

Histology is the study of tissue under a microscope. The term can be interchangeable with histopathology, which is the study of diseases present in tissue.

For mesothelioma, pathologists conduct histology testing by examining tissue extracted from someone who may have malignant cells. Doctors retrieve this tissue one of two ways: from a surgical biopsy, which involves a large incision; or from a needle biopsy, which requires a small incision.

Histology can be done in unison with cytology testing to study both tissue and fluid samples. However, tissue samples provide more conclusive evidence of whether or not mesothelioma is present. The tissue usually provides more cells to study, and the cells are easier to examine without fluid present.

Pathologists stain these cells to uncover the presence of cancer. This staining also allows the doctors to determine which mesothelioma cell type is primary. This knowledge can affect the patient’s treatment options and mesothelioma prognosis.