Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical hostory. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. Some hospitals will perform a physical examination, chest x-ray and lung functions test. The x-ray may reveals plueral thickening commonly seen after asbestos exposure and increase suspicion of mesothelioma. CT scan or MRI is performed 
and if a large amount of fluid is present, abnormal cells may be detected by sytology if this fluid is aspirated with syringe. For pleural fluid, this is done by a pleural tap or chest drain, in ascities with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absense of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made such as tuberculosis or heart failure.
and if a large amount of fluid is present, abnormal cells may be detected by sytology if this fluid is aspirated with syringe. For pleural fluid, this is done by a pleural tap or chest drain, in ascities with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absense of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made such as tuberculosis or heart failure.
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