Diagnostic tests for lung cancer

The goals of diagnostic testing in patients with suspected lung cancer are to establish the diagnosis and to determine the stage of the disease so that appropriate therapy can be initiated. Unless a patient has hemoptysis, fever, or a change in cough as an initial manifestation, resectable lung cancer will seldom be diagnosed on the basis of the history. Screening tests--particularly chest roentgenography--have usually identified the abnormality. The managing physician should then select diagnostic procedures that are associated with low risk and that will provide further diagnostic and staging information. A biopsy will almost always be necessary before definitive therapy can be planned. In many cases, a single procedure--for example, a needle biopsy of a hepatic lesion or biopsy of a supraclavicular lymph node--will provide a definitive diagnosis and establish the stage of the disease. The roles of cytology, histopathologic examination, radiologic studies, and various types of biopsy in the diagnosis of lung cancer are reviewed in this report.