The American Cancer Society indicates that some cases of lung cancer are detected via lung cancer screening, but the majority of lung cancer cases are discovered due to the manifestation of lung cancer symptoms or evaluation for another health issue. Every patient with suspected lung cancer should undergo a thorough history and physical examination.

It is important that when evaluating a patient suspected of having lung cancer, clinicians should differentiate non–small cell lung cancer (NSCLC) from small cell lung cancer (SCLC) in order to devise and implement appropriate treatment. SCLC is typically more aggressive than NSCLC and presents as a central lesion with hilar and mediastinal invasion along with regional adenopathy. At the time of diagnosis, the majority of patients with SCLC already have metastatic disease, and the most common sites of metastasis of lung cancer are the bones, liver, adrenal glands, pericardium, brain, and spinal cord.

The method by which cancer is diagnosed differs from individual to individual and is typically based on numerous factors, including medical history, patient symptoms, findings from physical examinations, and other test results, including hematological laboratory results.

After physical examination and complete blood count laboratory results, a chest x-ray is often the first test performed. Chest radiographs may reveal the following:

• Pulmonary nodule, mass, or infiltrate
• Mediastinal widening
• Atelectasis
• Hilar enlargement
• Pleural effusion

Examples of other diagnostic tests used for lung-cancer screening are imaging tests including computed tomography (CT) scans, MRI scans, or PET scans. There are several methods for confirming diagnosis, with the selection determined partly by lesion location. These methods include the following:

• Bronchoscopy
• Sputum cytology
• Mediastinoscopy
• Thoracentesis
• Thoracoscopy
• Transthoracic needle biopsy (CT- or fluoroscopy-guided)

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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