Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Adenocarcinoma Of The Lung

Diagnosis

Your doctor will ask you whether you smoke or whether you live with a smoker. If you smoke, your doctor will ask you how much you smoke and how long you have smoked. Your doctor also will ask whether you have worked in an industry where you may have been exposed to asbestos or other carcinogens.

Your doctor may suspect that you have some form of lung cancer based on your symptoms and your history. Your doctor will examine you, paying special attention to your lungs and chest. To confirm the diagnosis, your doctor will order a chest X-ray to see if there are any masses that could be cancer. If the X-ray shows anything suspicious, a computed tomography (CT) scan will be done to confirm the size and location of any mass or tumor. If cancer is suspected, further tests will be done to make the diagnosis, establish the specific type of lung cancer and determine how far it has spread. These tests may include:

• Sputum sample — In this test, coughed-up mucus is checked in the laboratory for cancer cells. With a test that evaluates the presence of cancer cells in the sputum. This is called sputum cytology.

• Biopsy — In this test, a sample of abnormal lung tissue is removed and examined under a microscope in a laboratory. Although this test often can be done using bronchoscopy, surgery sometimes is necessary to expose the suspicious lung area.

• Bronchoscopy — In this procedure, a tubelike instrument is passed into the lungs through the airways. The goal is to look for cancer inside of the lungs directly and to obtain a small piece of the lung for a biopsy.

• Mediastinoscopy — In this procedure, a tubelike instrument is used to biopsy lymph nodes or any masses seen between the lungs (the mediastinum). A biopsy obtained this way can diagnose the type of lung cancer and check to see if the cancer has spread to lymph nodes.

• Fine-needle aspiration — In this procedure, a tiny needle is inserted into a suspicious area of the lungs with the help of a CT scan done at the same time. The needle removes a small sample of tissue so it can be examined in a laboratory to diagnose the type of cancer.

• Thoracentesis — This procedure is used when lung cancer has caused fluid to accumulate in the chest. A sterile needle is used to withdraw a sample of the fluid so it can be examined in a laboratory.

• VATS (video-assisted thoracoscopy) — In this procedure, which can be both diagnostic and therapeutic, the surgeon places a flexible tube into an incision in the chest and can visually inspect the surrounding surfaces of the inner and outer linings of the lung area and even do surgery to remove abnormal areas. It is a less-invasive procedure compared to a larger operation, called a thoracotomy.

• CT, positron emission tomography (PET) and bone scans — These scans will check if lung cancer has spread to the brain, bones or other places in the body.