Squamous cell carcinoma of the lung other diagnostic studies: Difference between revisions
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{{Squamous cell carcinoma of the lung}} | {{Squamous cell carcinoma of the lung}} | ||
{{CMG}}; {{AE}} {{ | {{CMG}}; {{AE}} {{MV}} | ||
==Overview== | |||
Other diagnostic modalities for squamous cell carcinoma of the lung, include: thoracotomy, thoracoscopy, bronchoscopy, mediastinoscopy, transthoracic percutaneous [[fine needle aspiration]], and sputum cytology.<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref> | |||
==Other Diagnostic Studies== | |||
*Other diagnostic modalities for squamous cell carcinoma of the lung, include:<ref name="pmid24484269">{{cite journal |vauthors=Kinsey CM, Arenberg DA |title=Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging |journal=Am. J. Respir. Crit. Care Med. |volume=189 |issue=6 |pages=640–9 |year=2014 |pmid=24484269 |doi=10.1164/rccm.201311-2007CI |url=}}</ref> | |||
:*Thoracotomy | |||
:*Thoracoscopy | |||
:*Bronchoscopy | |||
::*Bronchoscopic specimens, include: | |||
::*Bronchial brush | |||
::*Bronchial wash | |||
::*Bronchioloalveolar lavage | |||
::*Transbronchial fine-needle aspiration (FNA) | |||
::*Core biopsy | |||
:*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 in non small cell lung cancer arranged from the most to the least invasive.<ref name="staging"> Lung Cancer Staging. Wikipedia.https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on March 1, 2015 </ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center | |||
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! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Procedure}} | |||
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Advantages}} | |||
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Disadvantages}} | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Thoracotomy]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Allows the most thorough inspection and sampling of lymph node stations | |||
*May be followed by resection of tumor, if feasible | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Invasive approach | |||
*Not indicated for staging alone | |||
*Significant risk of procedure-related morbidity | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Left parasternal mediastinotomy (or anterior mediastinotomy) | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Allows evaluation of the aortopulmonary window lymph nodes | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*More invasive | |||
*False-negative rate approximately 10% | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Chamberlain procedure | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Access to station 5 ([[aortopulmonary window]] lymph node) | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Limited applications, invasive | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Mediastinoscopy|Cervical mediastinoscopy]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Considered the gold standard (usual comparitor) | |||
*Excellent for 2RL 4RL | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*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% | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Thoracoscopy|Video-assisted thoracoscopy]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Useful for the evaluation of inferior mediastinum, station 5 and 6 lymph nodes | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Invasive | |||
*Does not cover superior anterior mediastinum | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Transthoracic percutaneous [[fine needle aspiration]] (FNA) under CT guidance | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Widely available than some other methods | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Traverses a lot of lung tissue | |||
*High pneumothorax risk | |||
*Some lymph node stations inaccessible | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Bronchoscopy]] with blind transbronchial FNA (Wang needle) | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Less invasive than above methods | |||
|style="padding: 5px 5px; background: #F5F5F5;"| | |||
*Relatively low yield | |||
*Not widely practiced | |||
*Bleeding risk | |||
|- | |||
|} | |||
==References== | ==References== |
Revision as of 20:23, 9 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Other diagnostic modalities for squamous cell carcinoma of the lung, include: thoracotomy, thoracoscopy, bronchoscopy, mediastinoscopy, transthoracic percutaneous fine needle aspiration, and sputum cytology.[1]
Other Diagnostic Studies
- Other diagnostic modalities for squamous cell carcinoma of the lung, include:[1]
- Thoracotomy
- Thoracoscopy
- Bronchoscopy
- Bronchoscopic specimens, include:
- Bronchial brush
- Bronchial wash
- Bronchioloalveolar lavage
- Transbronchial fine-needle aspiration (FNA)
- Core biopsy
- 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 in non small cell lung cancer arranged from the most to the least invasive.[2]
Procedure | Advantages | Disadvantages |
---|---|---|
Thoracotomy |
|
|
Left parasternal mediastinotomy (or anterior mediastinotomy) |
|
|
Chamberlain procedure |
|
|
Cervical mediastinoscopy |
|
|
Video-assisted thoracoscopy |
|
|
Transthoracic percutaneous fine needle aspiration (FNA) under CT guidance |
|
|
Bronchoscopy with blind transbronchial FNA (Wang needle) |
|
|
References
- ↑ 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.
- ↑ Lung Cancer Staging. Wikipedia.https://en.wikipedia.org/wiki/Lung_cancer_staging Accessed on March 1, 2015