Investigations of Malignant Mesothelioma

Malignant mesothelioma is an aggressive form of cancer affecting the pleura and the serous membranes. Asbestos exposure has been shown to be the most important factor contributing to the development of malignant mesothelioma. The current guidelines suggest that investigations and management of patients with mesothelioma require multidisciplinary teamwork, which allows for imple-mentation of structured diagnostic algorithms resulting in more efficient and timely diagnosis and implementation of therapeutic strategies. Majority of patients with malignant mesothelioma present with pleural effusion. Therefore imaging including thoracic ultrasound, computed tomography and Positron Emission Tomography form an important part of investigations. However, in the context of malignant mesothelioma each of these imaging modalities has its limitations. For this reason, invasive procedures such as thoracocentesis, medical or surgical thoracoscopy remain important tools for obtaining histological diagnosis of malignant mesothelioma. In this review, we will discuss investigational approaches applied in diagnosing malignant mesothelioma.