Diagnostic Tests for Lung cancer
Lung cancer: Diagnostic Tests
The list of diagnostic tests
mentioned in various sources as
used in the diagnosis of Lung cancer
includes:
Lung cancer Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Lung cancer:
- Smoking-Related Disorders: Home Testing:
- Lung & Respiratory Health Tests:
Lung cancer Diagnosis: Book Excerpts
Tests and diagnosis discussion for Lung cancer:
To help find the cause of symptoms, the doctor evaluates a
person's medical history, smoking history, exposure to
environmental and occupational substances, and family history
of cancer. The doctor also performs a physical exam and may
order a chest x-ray
and other tests. If lung cancer is suspected, sputum
cytology (the microscopic examination of cells obtained from a
deep-cough sample of mucus in the lungs) is a simple test that
may be useful in detecting lung cancer. To confirm the
presence of lung cancer, the doctor must examine tissue from
the lung. A biopsy
-- the removal of a small sample of tissue for examination
under a microscope by a pathologist
-- can show whether a person has cancer. A number of
procedures may be used to obtain this tissue:
-
Bronchoscopy .
The doctor puts a bronchoscope
(a thin, lighted tube) into the mouth or nose and down
through the windpipe to look into the breathing passages.
Through this tube, the doctor can collect cells or small
samples of tissue.
-
Needle
aspiration . A needle is inserted through the
chest into the tumor to remove a sample of tissue.
-
Thoracentesis .
Using a needle, the doctor removes a sample of the fluid
that surrounds the lungs to check for cancer cells.
-
Thoracotomy .
Surgery to open the chest is sometimes needed to diagnose
lung cancer. This procedure is a major operation performed
in a hospital.
(Source: excerpt from
What You Need To Know About Lung Cancer: NCI)
Diagnosis of Lung cancer: medical news summaries:
The following medical news items
are relevant to diagnosis of Lung cancer:
Diagnostic Tests for Lung cancer: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Lung cancer.
HEMOPTYSIS:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Routine diagnostic tests include a CBC, sedimentation rate, chemistry panel, coagulation profile, sputum smear, culture and sensitivity, a chest x-ray, and an EKG.
If a pulmonary embolism or infarction is suspected, arterial blood gases and a ventilation-perfusion scan should be ordered. In some cases, a pulmonary angiogram may be necessary. Objective testing for deep vein thrombosis with ultrasonography or impedance plethysmography may help confirm suspicion of a pulmonary embolism.
If tuberculosis is suspected, one should order a sputum or gastric washings for AFB smear, culture, and guinea pig inoculation. A tuberculin test should also be done. Apical lordotic views of the lung as well as lateral and oblique views may help identify a tuberculous cavity. There are serologic tests for antibodies against specific mycobacterial antigens.
Sputum cultures for fungi and skin tests for the various fungi may need to be done. If congestive heart failure is suspected, venous pressure and circulation time should be measured, and a pulmonary function test should be done. Echocardiography will help diagnose mitral stenosis.
A consultation with a pulmonologist and bronchoscopy need to be done if bronchogenic carcinoma or bronchiectasis is suspected. Other studies that are helpful in diagnosing bronchogenic carcinoma are sputa for Pap smear, transbronchial needle biopsy, and CT. MRI may confirm vascular etiologies for the bleeding such as pulmonary aneurysm. Serologic studies [ANA, antineutrophil cytoplasmic antibody (C-ANCA), etc.] may be useful in detecting collagen diseases. A bronchogram will be helpful in diagnosing bronchiectasis and foreign bodies.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Hemoptysis:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the hemoptysis is mild, ask the patient when it began. Has he ever coughed up blood before? About how much blood is he coughing up now and about how often? Ask about a history of cardiac, pulmonary, or bleeding disorders. If he’s receiving anticoagulant therapy, find out the drug, its dosage and schedule, and the duration of therapy. Is he taking other prescription drugs? Does he smoke? Ask the patient if he has had a recent infection. Has he been exposed to TB? When was his last tine test and what were the results?
Take the patient’s vital signs and examine his nose, mouth, and pharynx for sources of bleeding. Inspect the configuration of his chest and look for abnormal movement during breathing, the use of accessory muscles, and retractions. Observe his respiratory rate, depth, and rhythm. Finally, examine his skin for lesions.
Next, palpate the patient’s chest for diaphragm level and for tenderness, respiratory excursion, fremitus, and abnormal pulsations; then percuss for flatness, dullness, resonance, hyperresonance, and tympany. Finally, auscultate the lungs, noting especially the quality and intensity of breath sounds. Also auscultate for heart murmurs, bruits, and pleural friction rubs.
Obtain a sputum sample and examine it for overall quantity, for the amount of blood it contains, and for its color, odor, and consistency.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Hemoptysis:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the hemoptysis is mild, ask the patient when it began. Has he ever coughed up blood before? How much blood is he coughing up now and how often? Ask about a history of cardiac, pulmonary, or bleeding disorders. If he’s receiving anticoagulant therapy, find out which drug, its dosage and schedule, and the duration of therapy. Is he taking other prescription drugs? Does he smoke? Ask the patient if he has recently had any infections or been exposed to tuberculosis. When was his last tine test and what were the results?
Take the patient’s vital signs and examine his nose, mouth, and pharynx for sources of bleeding. Inspect the configuration of his chest and look for abnormal movement during breathing, use of accessory muscles, and retractions. Observe his respiratory rate, depth, and rhythm. Finally, examine his skin for lesions.
Next, palpate the patient’s chest for diaphragm level and for tenderness, respiratory excursion, fremitus, and abnormal pulsations; then percuss for flatness, dullness, resonance, hyperresonance, and tympany. Finally, auscultate the lungs, noting especially the quality and intensity of breath sounds. Also auscultate for heart murmurs, bruits, and pleural friction rubs.
Obtain a sputum specimen and examine it for overall quantity, for the amount of blood it contains, and for its color, odor, and consistency.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Hemoptysis:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
A focused physical examination should include vital signs and examinations of the nose, sinuses, oropharynx, neck, lungs, and heart. The neck should be palpated for the presence of lymphadenopathy and inspected for jugular venous distension. The lower extremities should be checked for edema. Examination of the skin may reveal lesions associated with systemic lupus erythematosus; Kaposi’s sarcoma; clubbing (consistent with neoplasm, bronchiectasis, or lung abscess); or ecchymosis related to a coagulopathy.
Testing
The evaluation should begin with a chest x-ray study to look for possible clues to the diagnosis: a mass lesion, focal or diffuse parenchymal disease, pneumonitis, abscess, infiltrate, hilar adenopathy, enlarged heart, pulmonary edema, coin lesion of aspergilloma, or the peribronchial cuffing suggestive of bronchiectasis. A computed tomography scan may be necessary to define a lesion seen on chest x-ray film (3). Additional basic testing should include a complete blood count with differential and a coagulation profile. For patients in whom infection is suspected, skin testing, a Gram’s stain, acid fast stain, or sputum cultures may be appropriate. Cytologic examination of the sputum is indicated in cases of suspected malignancy.
A. Other special tests. Fiberoptic bronchoscopy is used to localize the bleeding site of specific lesions noted on x-ray film. It is also used in cases of persistent or recurrent bleeding and for smokers aged more than 40 years with a negative chest x-ray study. Ventilation-perfusion scanning is indicated if pulmonary embolism is suspected.
Diagnostic assessment
Determining the site of bleeding is the first step. If the bleeding is from the nasopharynx or gastrointestinal tract then it is not classified as hemoptysis. The basic approach depends on the severity of the bleeding. Most cases of blood-tinged sputum are upper respiratory in nature and do not require extensive workup. Bronchitis is the most common cause. However, bronchogenic carcinoma and bronchiectasis are also common causes that do require further evaluation (4). Mild hemoptysis can be evaluated with elective bronchoscopy of the respiratory tract. Massive hemoptysis (definitions in the literature range from 100 ml/24 hours to 1,000 ml over several days) requires an emergent diagnostic approach, typically with rigid bronchoscopy (5). If hemoptysis persists despite treatment of a presumed infection, bronchial arteriography with embolization or resection of the involved segment may be necessary.
References
1. Colice GL. Hemoptysis: three questions that can direct management. Postgrad Med 1996;100(1):227–236.
2. DiLeo MD, Amedee RG, Butcher RB. Hemoptysis and Pseudohemoptysis: the patient expectorating blood. Ear Nose Throat J 1995;74(12):822–824, 826, 828.
3. Marshall TJ, Flower CD, Jackson JE. The role of radiology in the investigation and management of patients with hemoptysis. Clin Radiol 1996;51(6):391–400.
4. Marwah OS, Sharma OP. Bronchiectasis: how to identify, treat, and prevent. Postgrad Med 1995;97(2):149–150, 153–156, 159.
5. Cahill BC, Ingbar DH. Massive hemoptysis: assessment and management. Clin Chest Med 1994;15(1):147–167.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Hemoptysis:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
In primary care practice, neoplasm is the cause of less than 2% of cases of hemoptysis. A chest radiograph is nonetheless an essential component of the evaluation of every case of hemoptysis.
Differentiate hemoptysis from hematemesis. Hemoptysis is frothy, blood-tinged sputum that the patient can usually distinguish as coming from the lungs. Hematemesis is associated with nausea and vomiting, and it may be darker. Nasal or pharyngeal bleeding with posterior pharyngeal drainage could also be a source.
Clubbing indicates a chronic disorder and may be found in association with neoplasm, bronchiectasis, and lung abscess. Massive hemoptysis is usually due to lung cancer, tuberculosis, or aortic aneurysm.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Hemoptysis:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Take the patient’s vital signs and examine his nose, mouth, and pharynx for sources of bleeding. Inspect the configuration of his chest and look for abnormal movement during breathing, use of accessory muscles, and retractions. Observe his respiratory rate, depth, and rhythm. Finally, examine his skin for lesions.
Next, palpate the patient’s chest for diaphragm level and for tenderness, respiratory excursion, fremitus, and abnormal pulsations; then percuss for flatness, dullness, resonance, hyperresonance, and tympany. Finally, auscultate the lungs, noting especially the quality and intensity of breath sounds. Also auscultate for heart murmurs, bruits, and pleural friction rubs.
Obtain a sputum sample and examine it for overall quantity, for the amount of blood it contains, and for its color, odor, and consistency.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hemoptysis:
Diagnostic Approach
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
Age of Onset
In neonates,blood in tracheal aspirate signifies mucosal bleeding from aggressive suctioning,trauma from endotracheal tube, or pulmonary hemorrhage. With thelatter, there is usually a history of perinatal asphyxia, neonatalrespiratory distress syndrome, or septicemia.In infants, children, and adolescents,blood in mouth or upper airway is most commonly due to epistaxis,gingivitis, tonsillitis, nasopharyngeal trauma, retching duringvomiting, or persistent cough. Most common causes of persistentcough and hemoptysis are bronchitis, bacterial pneumonia, and cystic fibrosis. Evaluation
CBC, includingplatelet count, and chest radiography should be performed in anyindividual with hemoptysis. Depending on suspected diagnosis, otheruseful tests include tuberculin skin test, prothrombin and activatedpartial thromboplastin times, and sputum culture for bacteria, tuberclebacilli, and fungi.With suspected heart disease, chestradiography, ECG, and 2-D echocardiography are often diagnostic.Sometimes cardiac catheterization and angiography are necessary.Laryngoscopy and bronchoscopy helpdistinguish between upper and lower respiratory tract bleeding.Bronchoscopy may diagnose foreign body or bronchial tumor. Materialfrom this procedure may be collected for culture, acid-fast stain,cytology, and Prussian blue stain. The latter can demonstrate hemosiderin-ladenmacrophages, which are seen in hemosiderosis.Chest CT helps locate and define extentof any respiratory tract or mediastinal mass. It also can diagnoseand define extent of bronchiectasis.Angiography of bronchial and pulmonaryarteries may demonstrate site of focal, unilateral, massive bleeding.Hemoptysis combined with other evidenceof bleeding usually signifies a bleeding disorder. Diagnostic approachto these disorders is discussed in Chap.52, Purpura and Bleeding.
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Hemoptysis:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If hemoptysis is mild, ask the patient when it began. Has he ever coughed up blood before? About how much blood is he coughing up now and about how often? Ask about a history of cardiac, pulmonary, or bleeding disorders. If he's receiving anticoagulant therapy, find out the drug, its dosage and schedule, and the duration of therapy. Is he taking other prescription drugs? Does he smoke? Ask the patient if he has had a recent infection. Has he been exposed to TB? When was his last tine test and what were the results?
Take the patient's vital signs and examine his nose, mouth, and pharynx for sources of bleeding. Inspect the configuration of his chest and look for abnormal movement during breathing, the use of accessory muscles, and retractions. Observe his respiratory rate, depth, and rhythm. Finally, examine his skin for lesions.
Next, palpate the patient's chest for diaphragm level and for tenderness, respiratory excursion, fremitus, and abnormal pulsations; then percuss for flatness, dullness, resonance, hyperresonance, and tympany. Finally, auscultate the lungs, noting especially the quality and intensity of breath sounds. Also auscultate for heart murmurs, bruits, and pleural friction rubs.
Obtain a sputum specimen and examine it for overall quantity, for the amount of blood it contains, and for its color, odor, and consistency.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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