TY - JOUR T1 - Mesothelioma diagnosis in a district general hospital JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P1253 AU - Shashank Sharma AU - Katie Wimble AU - Behdad Shambayati AU - Michael Wood Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P1253.abstract N2 - Background: Malignant mesothelioma(MM) is a rare cancer with poor prognosis, posing a diagnostic challenge to respiratory physicians.Aim: We analysed our current diagnostic process for MM to assess the diagnostic yield of different investigative modalities.Methods: We analysed the effectiveness of various diagnostic modalities including pleural fluid cytology, CT or ultrasound guided(USG) core and thoracoscopically guided pleural biopsy over the last five years.Results: Of 55 patients diagnosed with MM since January 2007, 54 patients had confirmed cytological or histological diagnosis. 33(60%) patients had pleural fluid sent for cytology of which 17(51%) were positive for MM, 11(33%) negative, 3(9%) suspicious, 2(6%) showed a lung primary which eventually turned out to be MM and 3% inconclusive. 15 patients presented with pleural thickening or mass without pleural effusion. These patients were diagnosed with CT or USG biopsies. 26 patients underwent VATS.Interestingly, the percentage of patients that have been diagnosed positively on cytology has risen year on year(fig.1). PET scanning identifed an appropriate biopsy site in 4 of 8 patients scanned.Conclusion: We attribute the progressive increase in the cytological diagnoses made in our hospital to the increasing confidence of our cytologists in recognition of cytological features and use of wider immunocytochemical panels. PET can be instrumental in achieving the diagnosis in difficult cases. ER -