Lung Cancer

Lung Cancer

Diagnosis

  • CT scan - It is a diagnostic imaging procedure that uses x-rays to build cross-sectional images of a lung tumor and/or lung cancer metastases.
  • Positron emission tomography (PET) scan - Positron emission tomography (PET) scan does functional and morphological detail scanning by utilizing radiation derived from isotope labeled glucose molecules that enable detection of cellular glucose uptake in cancer.
  • Bone scan - A bone scan uses a radioactive tracer to rule out metastasis.
  • Blood Test - Tumor markers:
    Carcinoembryonic antigen (CEAs) - CEA assays aid in lung cancer clinical management.
  • Chromogranin A- It is a protein released from neuroendocrine cells that are found in patients with lung cancer.
  • Adrenocorticotropic hormone - It is found in patients with small cell carcinoma of the lung (SCLC).
  • Pathology
    • Tissue biopsy - A sample of tissue is removed from the patient and sent for pathology evaluation. This procedure can be performed by several methods, like Bronchoscopy, Mediastinoscopy or a guided needle biopsy.
      • Bronchoscopy is a procedure in which a doctor examines internal areas of the lungs using a lighted tube that is passed through the throat into the lungs.
      • Mediastinoscopy is a procedure in which an incision is made at the base of the neck, and surgical tools are inserted behind the breastbone to take tissue samples from lymph nodes in the area called Mediastinum.
      • Needle biopsy is a procedure where the doctor uses X-ray or CT images to guide a needle through the chest wall and into the lung tissue to collect a tissue sample.
      • EBUS- Endobronchial ultrasound is an outpatient procedure where a small tube is entered into the nostrils and reached into the windpipe to assess the adjacent structures around it. It is a non-invasive procedure where a tissue diagnosis can be obtained from the lymph nodes, which helps in diagnosing lung pathology.
      • Endo-ultrasound (EUS), in rare occasions where an endoscope is placed in the oral cavity and para-esophageal tissues like lymph nodes, etc., can be visualized and biopsied.
      • VATS Biopsy: In the present day standard of care, any suspicious lung nodule does not require needle biopsy if it is surgically operable. Present day standard of care is I-VATS biopsy for lung opacity.