Virginia Commonwealth University

VCU Massey Cancer Center

Diagnosis

How is lung cancer diagnosed?

In addition to a complete medical history (to check for risk factors and symptoms) and physical examination (to provide other information about signs of lung cancer and other health problems), procedures used to diagnose lung cancer may include:

  • Chest X-ray – these X-rays are used to look for any mass or spot on the lungs.
  • Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays. 
  • Needle biopsy – a needle is guided into the mass while the lungs are being viewed on a CT scan and a sample of the tissue is removed and evaluated in the pathology laboratory under a microscope. A lymph node biopsy also may be performed. Lymph nodes, located throughout the body, serve as filters and also help to fight infection. 
  • Bronchoscopy – the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to remove a foreign body. 
  • Mediastinoscopy – a process in which a small cut is made in the neck so that a tissue sample can be taken from the lymph nodes (mediastinal nodes) along the windpipe and the major bronchial tube areas to evaluate under a microscope. 
  • Video assisted thorcoscopic surgery (VATS) – performed using a small video camera that is introduced into the patient’s chest through a small cut. With the video camera, the surgeon is able to view the anatomy and other surgical instruments that are introduced into the chest through other small cuts. Traditional surgical approaches use a single large cut that is placed between the patient’s ribs. By using VATS, this large cut is avoided, thereby sparing the patient some of the postoperative pain and helping them have a quicker recovery. When it is possible to use this procedure, both tests to diagnosis lung cancer and surgery for treatment can be done this way. 
  • Positron emission tomography (PET) scan – radioactive-tagged glucose (sugar) is injected into the bloodstream. Tissues that use the glucose more than normal tissues (such as tumors) can be detected by a scanning machine. PET scans can be used to find small tumors or to check if treatment for a known tumor is working. 
  • X-rays and scans of the brain, liver, bone and adrenal glands – to determine if the cancer has spread from where it started into other areas of the body.

Other tests and procedures may be used as well.