6. Cytology Sputum microscopy is examined a sample of sputum to see if it contains cancer cells. * Needle biopsy: A needle is inserted into the mass while the lungs are displayed on a computer tomograph. Then a sample of the mass and observed through a microscope for cancer cells.

7. Bronchoscopy: We introduce a flexible, lighted tube through the mouth into the bronchi. This procedure can help find tumors located centrally or obstructions in the lungs. Also be used to take biopsies or remove fluids to be examined with a microscope to see if they contain cancer cells.

8. Mediastinoscopy: Make a small cut in the neck and a lighted tube is inserted behind the sternum. Can use special tools that are handled through this tube to take a sample of tissue from the mediastinal lymph nodes (along the trachea and main areas of bronchial tubes). The observation of the samples under a microscope can show if cancer cells.

9. Bone marrow biopsy: A needle is used to remove a cylindrical core of bone of approximately 1.5 mm wide and 2.5 inches long. Usually, the sample is taken from the back of the hip bone and studied under a microscope to see if cancer cells.

10. Blood tests: often perform certain blood tests to help detect if lung cancer has spread to the liver or bones, as well as for diagnosing certain paraneoplastic syndromes.# Cytology Sputum microscopy is examined a sample of sputum to see if it contains cancer cells. * Needle biopsy: A needle is inserted into the mass while the lungs are displayed on a computer tomograph. Then a sample of the mass and observed through a microscope for cancer cells.

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Bronchoscopy

It is a procedure designed to look inside the airways of the lungs. It involves inserting a thin, flexible tube down the throat into the airways. The tube allows the doctor to look inside. Your doctor might also take samples of tissues and cells (biopsy) during bronchoscopy.

Bronchial biopsy

Bronchial biopsy is performed by inserting a bronchoscope through the larynx of the patient. The bronchoscope is a camera that allows the doctor to see as you enter the unit. The bronchoscope is also a small hole that allows to remove pieces of tissue. These tissues are then sent to the laboratory for analysis.

Mediastinoscopy

This is the procedure that examines the mediastinum. This area is located in the center of the chest, right in the middle of the lungs and contains the heart, blood vessels and lymph nodes.

Needle biopsy

For this procedure, the doctor uses a fine needle to take samples and examine cells under a microscope. This test can be uncomfortable, but only takes a few minutes. The doctor may also use X-rays, CT scan or ultrasound to guide a biopsy needle during outpatient. The biopsy can be performed during surgery.

Wedge biopsy

For this procedure the surgeon makes an incision through the skin and removes a wedge of tissue from the tumor and sent to a lab for analysis. For this procedure, the patient must be under general anesthesia. Sometimes you use this type of biopsy when other biopsy methods have not been able to confirm a diagnosis.

Thoracoscopy (video-assisted VAT)

The doctor may request this procedure to drain fluid from the sac (pleura) that surrounds the lungs, also known as pleural effusion. This procedure can also be used to take samples of lung tissue or lymph nodes in the mediastinum. A tube with a scope on the tip, allows the doctor to see inside your chest. This tube also allows the physician to take samples of fluids, and sent to the pathology laboratory for analysis.

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- Chest radiograph with which you can see any mass or spot on the lungs and reasonably set the probability of being a cancer. This test is performed in two projections, one front and one in profile. For more than 95% of cancer cases their results are abnormal.

- TAC: It consists of an X-ray emission from different perspectives and with that seen throughout the body. It is a simple test which usually lasts more than 15-30 minutes. This is more sensitive than radiography and it detects more early-stage cancer. It also serves to check for metastasis to other organs: liver, adrenal glands, brain and so on. It is the most widely used imaging test and profitable in the study of this disease. However, sometimes required to complete the study of CT with other more sensitive tests for specific sites of lung cancer: magnetic resonance imaging (MRI) brain or spine, liver ultrasound, bone scan and so on.

- Magnetic resonance imaging is used to make detailed cross-sectional images. This technique uses magnetic fields and spectra emitted by phosphorus in body tissues and becomes the image. With it you can see the tumor vasculature. They are more accurate images with which one can observe the spread of cancer to the brain or spinal cord. It is often not too useful for exploring the lungs.

- Positron emission tomography (PET): involves injecting a drug radio combined with glucose and this will be taken up by cancer cells, cancer exist, they consume more glucose. The radio will be located drug areas where the tumor. In the case of lung cancer, is sometimes used to clear any doubts sown by the TAC, but is not necessary most of the time.

- Sputum cytology: We analyzed the first sputum or phlegm in the morning with a microscope to see if it contains cancer cells. Is a simple and very cost effective in lung cancers located in the bronchi.

- Tissue biopsy will be needed to confirm the diagnosis of lung cancer. This test involves taking a sample of suspicious tissue and microscopic analysis. The biopsy can be done by inserting a tube, a bronchoscope through the nose to where mass is in the lung. If the patient’s characteristics can not be done this type of biopsy, there will be a small operation to remove the tissue. After analyzing it, we can now determine the tumor type and stage and establish the appropriate treatment. Biopsies can be performed to analyze tissue from other areas, such as the lymph nodes, if metastasis is suspected.

- Mediastinoscopy and mediastinostomy: Most of the time, the TAC will be insufficient to provide essential information on whether the nodes of the mediastinum, in the center of the chest are affected or not. If in doubt, mediastinoscopy is used. This exam is done under general anesthesia, introduced under the sternum through a small incision at the base of the neck, a tube and optical system equipped with biopsy forceps.

- Blood tests can determine whether some functional or organic values are altered because of the disease and also help to determine the functional face of the person to treatment.

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