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Lung metastatic tumor diagnosis

Early stage lung cancer often has no symptoms. In addition, when symptoms appear, they can easily be mistaken for common respiratory illnesses such as bronchitis or pneumonia. Because of this, many cases are diagnosed at an advanced stage.

Patients at high risk for lung cancer, especially those with a history of smoking, should be tested regularly to detect lung cancer at an early stage, when there is a better chance of cure.

If you have symptoms of lung cancer, your doctor will ask you about your medical history, smoking and family history, and whether you have been exposed to certain chemicals or substances.

You will then undergo imaging tests, usually a chest X-ray. Images can't diagnose lung cancer, but they can show areas of concern. If the image shows such an area, the doctor may order other scans, including a CT scan or PET scan, to get more details about the area.

If an imaging scan indicates cancer, the doctor will order tissue or fluid to be removed from the lungs for examination. The act of taking a sample of tissue or fluid is called a biopsy. There are several ways a doctor can biopsy a lung tumor:

Needle biopsy: A CT-guided needle biopsy where the skin is punctured under local anesthesia to obtain a tumor sample. Fine needle aspiration (fna) is a needle biopsy that uses a very small needle and suction to remove a small amount of tissue.

Thoracocentesis: A needle is used to draw fluid from around the lungs to detect cancer cells.

Bronchoscopy: A thin, bendable tube with a tiny camera is passed through the nose or mouth and down into the lungs to obtain a small tissue sample (biopsy). This is usually done with light sedation. Bronchoscopy is rarely done alone. Bronchoscopy is usually performed under bronchial ultrasound.

Endobronchial ultrasound (EBUS) : A bronchoscope with an ultrasound device is used to check for lung cancer in nearby chest lymph nodes. EBUS is often performed in conjunction with bronchoscopy and requires general anesthesia.

Video-assisted thoracoscopic surgery (VATS) : This minimally invasive procedure uses a small camera to help extract tumor samples that would otherwise be difficult to obtain. Thoracoscopic surgery requires general anesthesia and is performed by a thoracic surgeon in the operating room.

Thoracoscopic/pleuroscopy: A thin, flexible tube with a tiny camera is inserted through a small incision in the back (thoracoscopic) or between the ribs (pleuroscopy). Doctors use the device to find and extract suspected cancer tissue.

To complete an assessment of how far the cancer has progressed, which is called staging, the patient will undergo a PET-CT scan and an MRI or CT scan to check if the cancer has spread to other organs, including the brain. This will guide treatment decisions for each lung cancer patient.

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