If bronchial carcinoma is suspected, an X-ray overview of the lungs usually provides initial information – and possibly a suspicious finding. Further examinations to confirm the diagnosis or to exclude lung cancer are in particular computer tomography and bronchoscopy (endoscopy of the respiratory tract) with taking tissue samples (biopsy). The diagnosis of lung cancer is often complicated because the symptoms are initially very unspecific.
If a tumor is detected, a number of further examinations (usually in the hospital) are necessary to determine the extent of the disease and to detect any concomitant diseases. Diagnostics are then used: the exact localization of the tumor (usually by computed tomography and chest x-ray), histological classification, exclusion of distant metastases (usually an ultrasound examination of the abdomen, computed tomography of the head and a skeletal scintigraphy are used to assess operability (this mainly involves parameters that allow conclusions to be drawn about the function of the lungs). If a tumor is detected, a series of further examinations (usually in hospital) are necessary to determine the extent of the disease and to detect any concomitant diseases. Diagnosis then serves as the basis for the diagnosis:
- The exact location of the tumor (usually by computed tomography and chest x-ray)
- The histological classification
- The exclusion of distant metastases (here, an ultrasound examination of the abdomen, a computer tomography of the head and a skeletal scintigraphy are usually used
- The evaluation of the operability (for this purpose, parameters are mainly collected which allow conclusions to be drawn about the function of the lungs)
Bronchoscopy
Bronchoscopy is used to examine the airways, i.e. the trachea and the large branches (bronchi). The term bronchoscopy is composed of the two Greek word parts “bronchus” (windpipe) and “skopein” (to look). Using a special endoscope (bronchoscope), a device consisting of a movable tube and a camera at the tip, the doctor can view the airways from the inside and thus detect, for example, endobronchial (tumor growth that has broken into the bronchi) tumor growth.
The bronchoscope is also equipped with a working channel for surgical instruments, through which tissue samples (biopsies) can be taken. This allows cells to be obtained directly from the tumor tissue, which can be used to determine the type of tumor present. In order to detect tumors that are inaccessible to the endoscope, the physician can additionally perform a bronchial lavage. In this procedure, the bronchial tubes are flushed with saline solution. After the rinsing, the solution is then examined in a laboratory for tumor cells, fungi or inflammatory lung diseases.