Thoracentesis is a procedure performed to alleviate the symptoms and discomfort associated with pleural mesothelioma. The most common symptom of pleural mesothelioma is pressure caused by the accumulation of fluid between the parietal pleura, or the lining covering the chest wall, and the visceral pleura, or the lining covering the lungs. The excess accumulation of fluid is called pleural effusion.
Thoracentesis Procedure
Thoracentesis treatment reduces the fluid associated with pleural effusion, in turn reducing the pressure on the lungs and chest wall. To perform this procedure, a syringe or catheter is inserted into the space between the lung and chest wall, and the fluid is aspirated (or removed).
The needle is normally inserted from the back, between the ribs and into the lung area. A small patch of skin is sterilized and numbing medication is injected into the area where the thoracentesis needle will be inserted. The procedure is short and relatively painless, and complications are rare. The medical terminology used to describe the results of the thoracentesis procedure is "pleural fluid aspiration."
Pleural Effusion
Mesothelial cells line the walls of the serous membranes that separate the major organs of the body. A small amount of fluid is normally produced by the mesothelial cells in order to provide a lubricant between the various organs and the chest wall. Pleural effusion occurs when there is an excessive build up of this fluid and is categorized into two types, exudates and transudates.
An exudative fluid is typically cloudy and contains many cells and proteins. Exudative fluid is often associated with diseases of the mesothelial cells, including mesothelioma. A transudate is a clear fluid that is common to the normal mesothelial cell's processes. The transudative fluid accumulates not because of diseases in the mesothelial cells, but because an imbalance occurs between the production and removal of the transudates.
In a completely balanced system, the appropriate amount of fluid produced by the mesothelial cells is absorbed by the blood and lymph vessels so that the pleural space does not become filled or extended. The most common cause of excessive transudative fluid is congestive heart failure. During congestive heart failure, the heart does not properly pump blood through the lungs and there is not enough blood flow to absorb the fluid in the pleural space.
Diagnostic Thoracentesis
Thoracentesis can also be conducted as a diagnostic procedure. The procedure is performed in the same fashion as during treatment, but less fluid is removed. After removal, the fluid is sent to a pathologist for evaluation. When a pleural effusion is first detected, it is common that a diagnostic thoracentesis is performed.
Pleural effusions are symptomatic of a number of abnormalities associated with the mesothelial cells, including mesothelioma. However, in many cases when cancer is present, the tests of the effusions provide negative or inconclusive results. Only in about 15 percent of the cases when cancer is present does an evaluation of the fluid provide a definitive diagnosis. Normally, a biopsy of pleural material is needed for specific diagnosis of mesothelioma.
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