Chest
Diagnosis of Lung Cancer*: The Guidelines
Section snippets
Recommendations
- 1.
In patients suspected of having SCLC based on the radiographic and clinical findings, the diagnosis should be obtained by whatever method is easiest (ie, sputum cytology, thoracentesis, FNA, or bronchoscopy, including TBNA), as dictated by the patient's presentation. Level of evidence, fair; benefit, moderate; grade of recommendation, B
- 2.
In patients suspected of having lung cancer who have an accessible pleural effusion, a definitive diagnosis of the pleural effusion via thoracentesis should be
Diagnosis of Primary Tumor
A variety of techniques (eg, sputum cytology, flexible bronchoscopy, and TTNA) are available as methods of achieving a definitive diagnosis. The selection of the most appropriate test is best performed in a multidisciplinary fashion. Four key questions on the diagnostic workup of patients with lung cancer were formulated and answered by a comprehensive review of the published literature performed by the Duke University Center for Clinical Health Policy Research. (Please refer to a previous
Conclusion
A variety of techniques is available to assist the clinician in achieving a definitive diagnosis of lung cancer. Selection of the most appropriate test is best done in a multidisciplinary fashion with input from a pulmonologist, chest radiologist, and thoracic surgeon. Furthermore, the most appropriate test is usually determined by the type of lung cancer (ie, SCLC or NSCLC), the size and location of the tumor, and the presumed stage of the cancer.
A diagnosis should be obtained by whatever
General Approach to Diagnosis
- 1.
In patients suspected of having SCLC based on the radiographic and clinical findings, the diagnosis should be obtained by whatever method is easiest (ie, sputum cytology, FNA, and bronchoscopy, including TBNA), as dictated by the patient's presentation. Level of evidence, fair; benefit, moderate; grade of recommendation, B
- 2.
In patients suspected of having lung cancer who have an accessible pleural effusion, a definitive diagnosis of the pleural effusion via thoracentesis should be made first.
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