A patient with a large, unexplained fluid accumulation in the chest or abdomen and who has a small or moderate amount of thickening of the pleura should have a biopsy performed, using semi-invasive techniques (techniques that require only local anesthesia and that do not involve cutting in to the chest or abdomen). For example, the biopsy might involve an initial thoracentesis (drainage of fluid) or paracentesis (drainage of fluid in the abdomen) and a pleural biopsy. These are relatively safe procedures that can be performed by a pulmonologist (lung physician), a radiologist, or a surgeon. A local anesthetic ( a numbing medicine such as lidocaine) is given to temporarily reduce the feeling in the area before the needle is inserted.
A thoracentesis can be performed after the pleural biopsy is completed. The doctor inserts a needle into the pocket of fluid in the chest of abdomen to draw off some of the fluid. Many times, the needle is simply used to insert a flexible catheter (a tube the size of thin spaghetti) which is then used to draw off the fluid. After the fluid is drawn out through the catheter, the catheter is removed.
A pleural biopsy with a special needle may help in getting a diagnosis of Mesothelioma, and it is generally performed by a pulmonologist. Since Mesothelioma is usually diffuse (widely scattered) in the chest, a random sample of the pleura may give tissue with Mesothelioma cells in it.
The fluid and the tissue from the pleural biopsy will be sent to a pathologist and/or cytologist who will look under the microscope at the fells and determine whether Mesothelioma is present. In the past, a diagnosis of Mesothelioma from fluid alone was possibly only a third of the time because of the difficulty of distinguishing between reactive and noncancerous cells and tumor cells. By staining the fluid with a special substance, pathologists can now make a diagnosis more easily. Your doctor will refer to these stains as "immunos", short for immunohistochemistry. You should make sure that any material used in the biopsy has been studied using these immuno stains. A chest x-ray is always performed after these procedures to make sure there were no complications from the biopsies, such as an accumulation of air in the chest (pneumothorax). The chest x-ray is also very important to see whether the majority of the fluid has been removed and if the lung is now able to expand with air and fill the chest cavity, as it normally should.
SOURCE:http://ezinearticles.com/?How-Are-Biopsies-Performed-and-Which-Biopsy-is-Best-For-Me?&id=4720298
A thoracentesis can be performed after the pleural biopsy is completed. The doctor inserts a needle into the pocket of fluid in the chest of abdomen to draw off some of the fluid. Many times, the needle is simply used to insert a flexible catheter (a tube the size of thin spaghetti) which is then used to draw off the fluid. After the fluid is drawn out through the catheter, the catheter is removed.
A pleural biopsy with a special needle may help in getting a diagnosis of Mesothelioma, and it is generally performed by a pulmonologist. Since Mesothelioma is usually diffuse (widely scattered) in the chest, a random sample of the pleura may give tissue with Mesothelioma cells in it.
The fluid and the tissue from the pleural biopsy will be sent to a pathologist and/or cytologist who will look under the microscope at the fells and determine whether Mesothelioma is present. In the past, a diagnosis of Mesothelioma from fluid alone was possibly only a third of the time because of the difficulty of distinguishing between reactive and noncancerous cells and tumor cells. By staining the fluid with a special substance, pathologists can now make a diagnosis more easily. Your doctor will refer to these stains as "immunos", short for immunohistochemistry. You should make sure that any material used in the biopsy has been studied using these immuno stains. A chest x-ray is always performed after these procedures to make sure there were no complications from the biopsies, such as an accumulation of air in the chest (pneumothorax). The chest x-ray is also very important to see whether the majority of the fluid has been removed and if the lung is now able to expand with air and fill the chest cavity, as it normally should.
SOURCE:http://ezinearticles.com/?How-Are-Biopsies-Performed-and-Which-Biopsy-is-Best-For-Me?&id=4720298
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