Peritoneal Mesothelioma Diagnosis

An accurate, complete diagnosis is essential for treating mesothelioma. Because there is no routine cancer, the OSUCCC – James’s world-renowned cancer specialists and sub-specialists reach across multiple disciplines and modes of treatment to offer patients the latest technologies and the most advanced procedures to understand mesothelioma at the molecular and genetic levels – the levels that drive each patient’s specific cancer. While there are currently no FDA-approved screening tests for peritoneal mesothelioma, the OSUCCC – James research specialists continue to develop and study blood-based tests for early detection.

The OSUCCC — James is home to world-renowned diagnostic experts in mesothelioma. If the disease is suspected, your OSUCCC – James specialists will examine you and ask you about your medical history, including information about symptoms and any risk factors you may have.

Depending on your symptoms, the experts will do a physical exam to check your overall health and look for signs of disease, like abdominal pain, swelling, lumps or anything else that seems unusual. Your general health habits, exposure to asbestos and past illnesses and treatments will also be discussed.

After the examination, they may also conduct the following tests to form a diagnosis:

Complete Blood Count and Blood Chemistry Studies

A blood sample is taken to measure the amounts of certain substances such as antibodies (proteins) released into the blood. Your specialists look for higher or lower than normal amounts of certain chemicals or proteins, which can signal disease in the organ or tissue that produces it.

Imaging Tests

Imaging tests produce pictures of the inside of the body, and they can help the experts determine the extent of the disease. Tests may include:

  • Chest X-Ray
    A painless test that uses electromagnetic waves to create a picture of the inside of your chest that enables the OSUCCC - James diagnostic experts to examine the organs and bones more closely. Enlarged lymph nodes or other enlarged organs can usually be seen on a chest X-ray.

  • CT Scan (Computed Tomography Scan)
    A type of X-ray test that produces detailed, cross-sectional images of your chest and abdomen from different angles. This procedure is also called computed tomography, computerized tomography or computerized axial tomography. A CT scan can show evidence of a tumor.

  • Magnetic Resonance Imaging (MRI)
    A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. Magnetic resonance imaging makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or X-ray.


During a biopsy, your mesothelioma specialists remove a small piece of tissue so that a specially trained OSUCCC – James pathologist can examine the cells under a microscope for any signs of cancer, DNA abnormalities or certain proteins on the surface of cancer cells. This can confirm a diagnosis and help the experts determine what type of cancer it is and the best course of personalized treatment.

Procedures used to collect the cells or tissues include:

  • Fine-needle (FNA) aspiration biopsy of the lung: Removing tissue or fluid using a thin needle. An imaging procedure locates the abnormal tissue or fluid in the lung, then a small incision can be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid, and a sample is removed.
  • Thoracoscopy: An incision is made between two ribs and a thoracoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted into the chest.
  • Thoracotomy: An incision is made between two ribs to check inside the chest for signs of disease.
  • Peritoneoscopy: An incision is made in the abdominal wall and a peritoneoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted into the abdomen.
  • Laparotomy: An incision is made in the wall of the abdomen to check the inside of the abdomen for signs of disease.
  • Open Biopsy: An incision is made through the skin to expose and remove tissues to check for signs of disease.
  • Cytologic Exam: Cells are examined under a microscope to check for anything abnormal. For mesothelioma, fluid is taken from the chest or from the abdomen so that a specially trained OSUCCC – James pathologist can check the fluid for signs of cancer.
  • Immunohistochemistry: A test that uses antibodies to check for certain antigens in a tissue sample. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.
  • Electron Microscopy: Cells in a tissue sample are viewed under a high-powered microscope to look for certain changes in the cells. An electron microscope shows tiny details better than other types of microscopes.

(Source: National Cancer Institute)

At the OSUCCC – James, the mesothelioma treatment team includes internationally recognized medical oncologists, surgical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, geneticists, pharmacists, nutritionists and more.

Also on that team are cancer researchers who help sequence tumors to identify key molecules that fuel each patient’s cancer and who then develop drugs that target only those particular molecules.

Working together and across medical disciplines, this super sub-specialized team develops individualized, highly targeted treatment plans that specifically target the molecular and biological makeup of your individual cancer.

If you’ve been diagnosed with mesothelioma, would like a second opinion or would like to speak with a cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210

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