The presence of lung cancer can be confirmed by performing a biopsy, a procedure in which a specialized doctor (a pathologist) removes small suspected tissue samples or fluids from the body to be examined later under a microscope for the presence of cancer cells. A biopsy also can be done to determine the type and stage of lung cancer.
Depending on the size and location of the tumor, there are several ways to obtain the tissue or fluid by biopsy:
Bronchoscopy is performed if a computerized tomography (CT) scan shows the presence of cancer in the central part of the chest. It is a procedure that allows a doctor or nurse to remove a small lung tissue sample (biopsy) with the help of a thin flexible tube, called a bronchoscope, which is inserted through the mouth or nose, down the throat, and into the airways. A small camera is used to look directly into the airways and the lungs. The procedure may be uncomfortable, but a mild sedative is given beforehand to help the patient relax, and a local anesthetic is used to numb the throat. The procedure takes only a few minutes.
Percutaneous needle biopsy
This procedure uses a hollow biopsy needle that is inserted through the skin to draw out suspected tumor tissue or fluid sample for testing in the laboratory for cancerous cells. A local anesthetic is used to numb the surrounding skin, and the needle is inserted through the skin into the lungs. Different types of needles are used and the procedure is usually done with the aid of imaging tests, such as a CT scan, fluoroscopy, ultrasound, or MRI, to guide the needle to the site of the suspected tumor.
Autofluorescence bronchoscopy uses a bronchoscope that is inserted into the lungs through the nose or mouth. A special light with a camera is used to capture live color video, which is viewed on a monitor. Under this light, abnormal or pre-cancerous tissue appears in a different color than normal tissue. This procedure gives more information than a traditional bronchoscopy. Tissue samples also can be removed for testing.
Endobronchial ultrasound (EBUS)
It is a type of ultrasound (high frequency sound waves) combined with a bronchoscope, which is inserted through the mouth. This procedure allows for better examination of the lymph nodes and other structures in the center of the chest to see if the cancer has spread. Tissue samples also may be removed.
Mediastinoscopy is a surgical procedure in which an incision is made just above the breastbone (or at the bottom of the neck) to allow a device, attached to a camera, to pass into the middle of the chest (mediastinum). It can be used to look for the presence of cancer in the mediastinum or the central lymph nodes (the lymph nodes are the sites where the cancer spreads first). Tissue samples also my be removed for testing. A general anesthetic is given prior to a mediastinoscopy and the patient may need to stay in the hospital for a couple of days.
A hollow needle is used to draw fluid, accumulated between the lungs and the chest wall, which is then tested for the presence of cancer cells.
Thoracoscopy is a surgical procedure in which an incision (or cut) is made in the chest wall to allow a device/tube (similar to a bronchoscope), which is attached to a camera, to be inserted into the lungs so that the lungs and the surrounding area can be explored. Tissue samples also may be removed for testing. A general anesthetic is given prior to thoracoscopy and the patient may need to stay in the hospital overnight.
This procedure uses a bronchoscope to reach the lungs with the help of a CT scan and a GPS-like technology, which are used to create a map and navigate to the tumor site. It allows doctors to get to the outer areas of the lungs, which can be difficult to reach using traditional bronchoscopy.
Note: Lung Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.