Diagnosing a case of pleural mesothelioma usually starts with the patient experiencing common symptoms. These include coughing (a dry cough), coughing up blood, chest pain, difficulty eating or swallowing, sudden weight loss, fatigue, lumps under the skin of the chest, shortness of breath or painful breathing, night sweats, and swelling of the face or arms. When a patient presenting possible symptoms of pleural mesothelioma visits a doctor, the physician will use tests and imaging scans to make a diagnosis.