Pancoast tumor other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Other diagnostic studies for evaluating the spread of Pancoast tumor include pulmonary angiography, molecular tests, and biopsy.

Other diagnostic studies for evaluating the spread of Pancoast tumor include pulmonary angiography, molecular tests, and biopsy.

• On pulmonary angiography, findings of Pancoast tumor may be used for:^[1]

• Evaluation of central pulmonary artery invasion

Molecular tests include epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) mutation. Specific targeted agents may be administered to patients if these mutations are present. A transthoracic needle biopsy and a bronchoscopy are conducted to diagnose lung cancer.

A transthoracic needle biopsy, guided by CT or fluoroscopy, is for pancoast tumors located in the periphery of the lungs since peripheral tumors are not accessible through a bronchoscope.^[2][3]

• Other diagnostic modalities for pancoast tumor include:^[2]

• Thoracotomy
• Thoracoscopy
• Mediastinoscopy

• Chamberlain procedure
• Left parasternal mediastinotomy
• Anterior mediastinotomy

• Transthoracic percutaneous fine needle aspiration
• Sputum cytology

• The sensitivity or sputum cytology varies by location of the lung cancer

• The majority of these procedures allow staging of mediastinal lymph nodes.
• The table below summarizes the different types of diagnostic modalities for Pancoast tumor arranged from the most to the least invasive.^[4]

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