Which diagnostic procedure yields pleural tissue for histologic confirmation of mesothelioma?

Which diagnostic procedure yields pleural tissue for histologic confirmation of mesothelioma?

• A. VATS pleural biopsy
• B. Bronchoscopy
• C. Thoracentesis only
• D. Percutaneous liver biopsy

Answer: (A)

The key idea is that confirming mesothelioma requires pleural tissue for histology, not just fluid analysis. VATS pleural biopsy provides direct visualization of the pleura and allows taking multiple targeted pleural biopsies under anesthesia, giving adequate tissue for microscopic examination and immunohistochemical staining. This combination is essential to distinguish mesothelioma from reactive changes or other cancers and to establish a definitive diagnosis. Bronchoscopy mainly samples the airways and lung tissue, not the pleural surfaces, so it’s unlikely to yield diagnostic pleural tissue for mesothelioma. Thoracentesis collects pleural fluid and may offer cytology, but tissue biopsy is typically needed for definitive confirmation. A percutaneous liver biopsy targets the liver and has no role in diagnosing pleural mesothelioma.

The key idea is that confirming mesothelioma requires pleural tissue for histology, not just fluid analysis. VATS pleural biopsy provides direct visualization of the pleura and allows taking multiple targeted pleural biopsies under anesthesia, giving adequate tissue for microscopic examination and immunohistochemical staining. This combination is essential to distinguish mesothelioma from reactive changes or other cancers and to establish a definitive diagnosis.

Bronchoscopy mainly samples the airways and lung tissue, not the pleural surfaces, so it’s unlikely to yield diagnostic pleural tissue for mesothelioma. Thoracentesis collects pleural fluid and may offer cytology, but tissue biopsy is typically needed for definitive confirmation. A percutaneous liver biopsy targets the liver and has no role in diagnosing pleural mesothelioma.