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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Large cell carcinoma of the lung other diagnostic studies

Introduction

Overview

Overview

Other diagnostic studies for large cell carcinoma of the lung, may include: transthoracic percutaneous fine needle aspiration, thoracotomy, and mediastinoscopy.[1]

Other Diagnostic Studies

Other Diagnostic Studies

  • Other diagnostic modalities for large cell carcinoma of the lung, include:[1]
  • Thoracotomy
  • Thoracoscopy
  • Bronchoscopy
  • Bronchoscopic specimens, include:
  • Bronchial brush
  • Bronchial wash
  • Bronchioloalveolar lavage
  • Transbronchial fine-needle aspiration
  • Core biopsy
  • Mediastinoscopy
  • Chamberlain procedure
  • Left parasternal mediastinotomy
  • Anterior mediastinotomy
  • 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 in non small cell lung cancer arranged from the most to the least invasive.[2]
Procedure Advantages Disadvantages
Thoracotomy
  • Allows the most thorough inspection and sampling of lymph node stations
  • May be followed by resection of tumor, if feasible
  • Invasive approach
  • Not indicated for staging alone
  • Significant risk of procedure-related morbidity
Anterior mediastinotomy
  • Allows evaluation of the aortopulmonary window lymph nodes
  • More invasive
  • False-negative rate approximately 10%
Chamberlain procedure
  • Limited applications, invasive
Cervical mediastinoscopy
  • Considered the gold standard (usual comparitor)
  • Excellent for 2RL 4RL
  • Invasive
  • Does not cover all mediastinal lymph node stations; particularly subcarinal lymph nodes (station 7), paraesophageal and pulmonary ligament lymph nodes (stations 8 and 9).
  • False-negative rate approximately 20%
Video-assisted thoracoscopy
  • Useful for the evaluation of inferior mediastinum, station 5 and 6 lymph nodes
  • Invasive
  • Does not cover superior anterior mediastinum
Transthoracic percutaneous fine needle aspiration under CT guidance
  • Widely available than some other methods
  • Traverses a lot of lung tissue
  • High pneumothorax risk
  • Some lymph node stations inaccessible
Bronchoscopy with blind transbronchial fine needle aspiration
  • Less invasive than above methods
  • Relatively low yield
  • Not widely practiced
  • Bleeding risk
References

References

  1. ↑ 1.0 1.1 Kinsey CM, Arenberg DA (2014). “Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging”. Am. J. Respir. Crit. Care Med. 189 (6): 640–9. doi:10.1164/rccm.201311-2007CI. PMID 24484269.
  2. ↑ Lung Cancer Staging. Wikipedia.https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on March 1, 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]