Mesothelioma Thoracentesis

Though researchers continue to develop new ways to diagnose and treat mesothelioma, there are a number of techniques that have been on the scene for several decades. One such technique, thoracentesis, was developed in the late 19th century and is still used today.

Thoracentesis, the extraction of fluid from the lungs and the pleura (pleural effusion), can be used for two purposes. The first is as a diagnostic tool. In this procedure, a doctor uses a hollow needle, or cannula, to extract pleural fluid. This procedure helps to determine the causes behind the fluid buildup. The fluid is then examined for certain qualities that may indicate disease. Usually, however, thoracentesis is not sufficient to determine whether or not a person has mesothelioma. A biopsy is typically required as well.

Before performing the test, doctors will first take an x-ray of the chest, which reveals the extent of the problem and allows them to make the best insertion possible. The skin around the insertion will be disinfected and local anesthesia will be injected to numb the pain. The needle is then inserted. This may cause a feeling of pressure, but not pain (with the help of anesthesia). The procedure is often followed by an x-ray to verify the success of the thoracentesis and the amount of fluid removed.

After the fluid is collected from the lung's chest cavity, it is sent to a lab for analysis. There are a number of factors that doctors examine to determine whether mesothelioma is present. These include:

• Protein levels
• Glucose presence
• pH levels
• Cell count
• Cholesterol

Fluid in the pleural region can indicate a number of concerns other than mesothelioma. Although cancer is a common cause of excess fluid in the chest, the fluid may also indicate lung infection, connective tissue disease, congestive heart failure, cirrhosis, and a number of other conditions.

Thoracentesis may also be used for palliative reasons to treat the uncomfortable and often debilitating symptoms of pleural effusion. Removing the fluid lessens pressure on the chest and lungs, eases pain in those areas, and provides more space for the lungs to expand.

Thoracentesis is not without risk. Some of the complications that may occur include the following:

• Pneumothorax: This condition, better known as a collapsed lung, can occur if the doctor accidentally punctures the lung or disrupts an accumulation of air in the pleural cavity.
• Hemopneumothorax: Often causing the lung to collapse, hemopneumothorax takes place when damage occurs and blood begins filling the pleural space.
• Pulmonary edema: While removing a sample of the fluid in the lung area is supposed to help, it can sometimes cause even more fluid buildup in the pleural space or swelling. This condition is known as pulmonary edema and can lead to lung failure.

There are also a number of minor conditions that may develop as a result of the thoracentesis procedure. These include subcutaneous hematoma (slight bruising or bleeding), anxiety, and cough.

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