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Diagnosis of Lung Cancer

There are two main types of lung cancer. Treatment varies because each type grows and spreads in different ways.

  • Non-small cell lung cancer, the most common, is often associated with smoking. Three subtypes differ in size, shape and chemical composition.
  • Small cell lung cancer accounts for about 20 percent of cases.

Imaging Tests

Physicians use several techniques to locate abnormal areas and determine the extent of the disease. These tools provide critical information used to develop an individualized treatment plan.

  • Chest X-rays are used to identify spots on the lung.
  • Computed tomography (CT) offers precise information about the size, shape and location of the tumor.
  • Lo- dose CT (spiral CT) gives more detailed pictures than a chest X-ray. It can find small tumors and exposes patients to less radiation than a standard CT.
  • Magnetic resonance imaging (MRI) produces detailed pictures of soft tissue that determine if cancer has spread to the brain and spinal cord.
  • Positron emission testing (PET) helps determine if cancer has spread to lymph nodes or elsewhere.
  • Combined PET/CT provides enhanced capabilities for imaging lung cancer that is sometimes difficult to identify on a typical CT scan.
  • Bone scans are used to detect whether lung cancer has spread to the bone.


During a bronchoscopy, physicians use a lighted, flexible tube called a bronchoscope to detect tumors or suspicious cells. Tissue samples can be removed from the bronchial passages for analysis.

Mediastinoscopy is a surgical staging procedure using a long, thin, flexible, lighted tube to view and biopsy the area behind the breastbone and between the lungs, or mediasteium, This allows the medical team to determine whether or not cancer had spread to any lymph nodes in that area.

Electromagnetic Navigation Bronchoscopy

This procedure uses a device known as the iLogic or SuperDimension system, a navigational system for the lungs. Aided by a video monitor, the physician guides a flexible catheter through very delicate vessels of the bronchial tree to reach small lung lesions for biopsy and, in some cases, treatment.

Endobronchial Ultrasound (EBUS)

Endobronchial ultrasound, or EBUS, is used to diagnose and stage lung cancer without conventional surgery. The device is inserted through a bronchoscope in the airway, allowing doctors to view and biopsy lymph nodes or another area of concern.

Endoscopic Esophageal Ultrasound

A small flexible tube with an ultrasound machine on the tip is placed inside the esophagus. The device can examine growths and tumors located in the wall of the esophagus or in the structures surrounding the esophagus.

CT-Guided Biopsy

Guided by computed tomography (CT) imaging, doctors use a fine needle to remove or aspirate tissue samples that are not accessible during a bronchoscopy.

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Rita Appel

Breathing Easier

Rita Appel, 68, of Westport never expected that an annual checkup with her primary care physician would lead to a visit with a pulmonologist and a diagnosis of lung cancer – nearly 40 years after quitting smoking.