It is more common than one might think for there to be a misdiagnosis of mesothelioma in cases of asbestos related disease, particularly where there is a spurious history of exposure.
We have recently dealt with cases where there were initial diagnoses of asbestos related mesothelioma, but subsequently a final diagnosis of pseudomesotheliomatous adenocarcinoma. This is a cancer which mimics the symptomology of asbestos related mesothelioma.
It can be difficult to differentiate between mesothelioma and non asbestos related cancers, particularly pre-mortem. Initially, microscopy and cytological testing can be undertaken at the hospital and are used to form an initial diagnosis. No single structural feature on microscopy is a characteristic of mesothelioma, and cytological diagnosis of mesothelioma is difficult.
Despite this, too many coroners fail to order a post mortem which means there are still many diagnoses of this condition which do not take the further step of histochemical and immunohistochemical testing. These tests are vital in ensuring a more accurate diagnosis. A full panel of tests and chemical staining should always be carried out before it is accepted that mesothelioma is present.
The typical panel of histochemical and immunohistochemical tests undertaken are as follows:
Click here to view the table.
A diagnosis of mesothelioma is one based on exclusion and there is no one single marker, which is why a panel of testing is undertaken. The above tests will need to be considered as a whole, in case individual results are inconsistent with the above table.
Given the potential level of damages where mesothelioma is established, knowledge of the methodology of diagnosing the condition is always useful. An initial check of the medical records is a sensible starting point.