Mesothelioma Diagnosis Cheat Sheet 2026

The 30 highest-yield Mesothelioma Diagnosis facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which imaging study is most useful for assessing the extent of chest wall invasion in mesothelioma? → MRI
2. Which imaging finding would most likely prompt a change from surgical to palliative management in pleural mesothelioma? → Mediastinal lymph node involvement on PET/CT
3. Which characteristic morphological feature differentiates epithelioid mesothelioma from reactive mesothelial hyperplasia on histology? → Stromal invasion
4. Which IHC profile helps distinguish pleural mesothelioma (positive) from metastatic adenocarcinoma (negative)? → Calretinin positive, CEA negative
5. Which radiologic sign on chest X-ray suggests mesothelioma has encased and contracted the affected hemithorax? → Ipsilateral volume loss with pleural thickening
6. Fibulin-3 as a mesothelioma biomarker is measured in which biological fluid? → Plasma and pleural fluid
7. Peritoneal mesothelioma must be differentiated from primary peritoneal carcinoma by which IHC finding? → Calretinin and WT1 positive vs. PAX8 and ER positive in carcinoma
8. CT-guided core needle biopsy of a pleural mass in suspected mesothelioma is preferred over fine needle aspiration (FNA) because: → It provides tissue architecture needed for subtyping
9. Weight loss greater than 5% of body weight in mesothelioma patients is significant because: → It is an independent predictor of poor prognosis and is part of prognostic scoring systems
10. TTF-1 (thyroid transcription factor-1) positivity in a pleural biopsy would support a diagnosis of: → Metastatic lung adenocarcinoma
11. Superior vena cava (SVC) syndrome developing in a mesothelioma patient most likely results from: → Direct tumor compression or invasion of the SVC or mediastinum
12. What does T4 disease represent in the IMIG staging of pleural mesothelioma? → Direct extension into contralateral pleura, spine, or heart
13. Which mesothelial lesion is classified as a precursor to mesothelioma and shows malignant cells confined to the mesothelial surface? → Mesothelioma in situ
14. Extrapleural pneumonectomy (EPP) is a surgical option for which stage of mesothelioma? → Stage I or II epithelioid mesothelioma in fit patients
15. Pericardial mesothelioma most commonly presents with which symptoms? → Palpitations, chest pain, and dyspnea due to pericardial effusion
16. Which IHC marker is typically negative in mesothelioma but positive in metastatic breast carcinoma to the pleura? → GATA3
17. Which of the following best explains why mesothelioma is frequently misdiagnosed at initial presentation? → Early symptoms mimic common benign conditions like pleuritis or pneumonia
18. In the IMIG TNM staging system, Stage I mesothelioma is characterized by: → Tumor confined to the ipsilateral pleura without nodal involvement
19. Pleural plaques seen on CT are important in mesothelioma diagnosis because they indicate: → Prior asbestos exposure
20. Why is pleural biopsy via Abrams needle less preferred than VATS for mesothelioma diagnosis? → It provides smaller, less representative samples with lower diagnostic yield
21. Which condition most commonly causes benign pleural thickening that mimics mesothelioma on imaging? → Fibrothorax from prior empyema or hemothorax
22. What is the rarest form of mesothelioma by anatomical location? → Testicular mesothelioma
23. Cytoreductive surgery plus HIPEC for peritoneal mesothelioma is associated with median survival of approximately: → 40–60 months
24. Immunohistochemistry (IHC) is essential in mesothelioma pathology primarily to: → Distinguish mesothelioma from adenocarcinoma
25. What does an elevated serum CRP (C-reactive protein) indicate in the context of mesothelioma? → Active systemic inflammation associated with worse prognosis
26. Which occupational group historically has the highest risk of developing mesothelioma? → Shipyard workers
27. Solitary fibrous tumor of the pleura (SFTP) is distinguished from mesothelioma by which key feature? → It is usually localized and has a pedunculated attachment to the pleura
28. Pleural involvement by thymoma (type B3) may mimic biphasic mesothelioma; which FISH finding confirms thymoma? → Absence of CDKN2A deletion and presence of chromosome 6 abnormalities
29. What is the clinical utility of serum SMRP levels in mesothelioma? → Monitoring disease progression and treatment response
30. Which paraneoplastic syndrome is occasionally reported in association with mesothelioma and can complicate clinical evaluation? → Hypercalcemia of malignancy due to PTHrP secretion