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Selection of modality for diagnosis and staging of patients with suspected non-small cell lung cancer

Authors
Karl W Thomas, MD
Michael K Gould, MD, MS
Section Editor
David E Midthun, MD
Deputy Editor
Geraldine Finlay, MD

INTRODUCTION

Non-small cell lung cancer (NSCLC) accounts for approximately 85 percent of all lung cancers [1]. The two most common histopathologic subtypes are adenocarcinoma followed by squamous carcinoma. Tissue biopsy is necessary for the diagnosis of NSCLC. It is especially important that enough tumor tissue is obtained to allow for accurate histopathologic and molecular assessment so that appropriate therapies can be administered in a timely fashion. (See "Personalized, genotype-directed therapy for advanced non-small cell lung cancer".)

This topic will discuss the general approach to selecting a modality to obtain tissue from a target biopsy site (primary tumor, lymph node, distant metastasis) for the histopathologic diagnosis and staging of NSCLC. The approach to patients with a solitary pulmonary nodule, overview of the initial evaluation and imaging of NSCLC, procedures used for tissue biopsy of NSCLC, and the 7th edition of the Tumor Node Metastasis staging system for NSCLC are discussed in detail separately. (See "Diagnostic evaluation and management of the solitary pulmonary nodule" and "Overview of the risk factors, pathology, and clinical manifestations of lung cancer" and "Overview of the initial evaluation, treatment and prognosis of lung cancer" and "Overview of the initial evaluation, diagnosis, and staging of patients with suspected lung cancer" and "Procedures for tissue biopsy in patients with suspected non-small cell lung cancer" and "Tumor, node, metastasis (TNM) staging system for non-small cell lung cancer".)

BIOPSY INDICATIONS

Histopathology is essential for the diagnosis of all types of lung cancer. A tissue biopsy is required to achieve the following goals:

Determine whether the primary lesion is malignant or benign

Distinguish primary lung cancer from a metastasis of a non-pulmonary primary site

                    

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Literature review current through: Nov 2016. | This topic last updated: Thu Jul 14 00:00:00 GMT 2016.
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