Establishing The Diagnosis Of Lung Cancer: Diagnosis And Management Of Lung Cancer

Publication Date: May 1, 2013
Last Updated: March 14, 2022

Recommendations

Diagnosis of Pleural Abnormalities

In patients suspected of having SCLC based on the radiographic and clinical findings, it is recommended that the diagnosis be confirmed by the least invasive method (sputum cytology, thoracentesis, FNA, bronchoscopy including TBNA), as dictated by the patient’s presentation. (1, C)
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In patients suspected of having lung cancer, who have extensive infiltration of the mediastinum based on radiographic studies and no evidence of extrathoracic metastatic disease (negative PET scan), it is recommended that the diagnosis of lung cancer be established by the least invasive and safest method (bronchoscopy with TBNA, EBUS-NA, EUS-NA, TTNA, or mediastinoscopy). (1, C)
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In patients suspected of having lung cancer who have a solitary extrathoracic site suspicious of a metastasis, it is recommended that tissue confirmation of the metastatic site be obtained if a FNA or biopsy of the site is feasible. (1, C)
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In patients suspected of having lung cancer, who have lesions in multiple distant sites suspected of metastases but in whom biopsy of a metastatic site would be technically difficult, it is recommended that diagnosis of the primary lung lesion be obtained by the least invasive method. (1, C)
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In patients suspected of having lung cancer who have an accessible pleural effusion, thoracentesis is recommended to diagnose the cause of the pleural effusion. (1, C)
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In patients suspected of having lung cancer who have an accessible pleural effusion, if pleural fluid cytology is negative, pleural biopsy (via image-guided pleural biopsy, medical or surgical thoracoscopy) is recommended as the next step. (1, C)
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Overview

Title

Establishing The Diagnosis Of Lung Cancer: Diagnosis And Management Of Lung Cancer

Authoring Organization

American College of Chest Physicians