[Diagnosis of primary lung cancers]

Symptoms of bronchial cancers are varied and misleading, source of late diagnosis which had to be avoided by systematic suspicion in front of all symptoms from a "high-smoker". Fiberoptic bronchoscopy is the best exam for anatomic diagnosis of central forms. It is normal in peripheral forms but may yet be useful by directed samplings. If negative, it may be necessary to perform thoracotomy or transthoracic needle punction if surgery is contra-indicated. Pretherapeutic assessment of loco-regional and metastatic extension has recently profited by new imaging and endoscopic techniques, useful to the best realisation of TNM classification.