If lung cancer is suspected based on existing symptoms, a series of studies is necessary to establish a diagnosis. First, the so-called basic diagnostics is carried out, which includes examinations performed in almost all patients.

Diagnostic measures for lung cancer include:

— Anamnesis and examination of the patient, laboratory tests

They are a permanent part of every medical examination. And they give information about the physical and mental state of the patient. Important symptoms that can be detected in this case are pain, respiratory disorders, respiratory noises.

— Methods for obtaining tissue samples:

  • Microscopic examination of sputum

Sputum that is coughed up contains cells that have shed from the tissue that lines the inside of the bronchi or other parts of the lungs. In lung cancer, sputum may contain tumor cells. They allow, under certain conditions, to accurately determine the type of lung cancer. If cancer cells are not found in the sputum, this does not exclude the diagnosis of lung cancer.

  • Bronchoscopy (endoscopic examination of the airways)

This is the most important test in the diagnosis of lung cancer. During bronchoscopy, the airways are examined using an endoscope.

If the suspicious tumor is located in the central region of the lungs, which can be reached through the large bronchi, then bronchoscopy is performed. In this case, a thin, flexible tube with a light source at the end is inserted through the trachea into the bronchi. Optics allows you to see the internal structure of the respiratory tract. At the end of the tube is a camera. Small instruments can be inserted through the same tube. In this way, suspicious regions can be directly examined and tissue samples can be taken with small forceps for microscopic examination. The information obtained from microscopic examination is of great importance for accurate therapy planning.

  • Taking tissue samples through the chest wall

If suspicious tissue is close to the chest wall, a needle can be used to make a puncture from the outside through the chest wall into the tumor and take a tissue sample. The correct position of the needle is then controlled by an imaging technique, such as computed tomography.

  • Taking tissue fluid from the pleural cavity

In lung cancer, tissue fluid may leak into the pleural cavity (pleural effusion). From such an effusion, a fluid sample can be taken with a needle.

- X-ray of the chest and especially the lungs

X-ray of the lungs is carried out quickly and without special preparation. In this case, the radiation dose is negligible. This examination gives the first picture of disease processes in the chest. Perhaps after this study, the suspicion of lung cancer can be ruled out. If the suspicion remains, then further studies can be purposefully prescribed. Carcinomas in the central region of the lungs are often poorly recognized on x-rays.

— Computed tomography (CT) of the chest

CT, being the next stage in the development of X-ray technology, provides a three-dimensional image of the body. With its help, you can accurately determine the changes in individual organs and areas of the body. The location of the tumor, its size, often and metastases to the thoracic lymph nodes or distant parts of the body can be determined. In addition, during a CT scan, a thin needle can be used to purposefully take a sample of tissue for microscopic examination through the chest wall. This is done especially when the tumor is located on the periphery of the lungs (close to the chest wall). These sites cannot be reached with normal bronchoscopy.

– Magnetic resonance imaging (MRI)

An MRI uses a strong magnetic field to create a three-dimensional picture of the body. When diagnosing lung cancer, MRI is used primarily to look for metastases in the brain, while computed tomography is usually used to image other parts of the body.

– Skeletal bone scintigraphy (in combination with CT or ultrasound)

This method is used to search for bone metastases, especially in cases where it is not possible to perform a PET examination.

– Positron emission tomography (PET)

PET is a special study that provides information about metabolic activity in certain parts of the body. Together with a CT scan, it allows even more reliable recognition of cancerous tissue. PET is required to be performed as early as possible.

Doctor of Medical Sciences
Head of the pulmonology clinic
Professor, MD, PhD
Head of the pulmonology clinic