NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 37

37
NCCN Guidelines for Patients
®
: Non-Small Cell Lung Cancer
Version 1.2014
Part 5: Tests by cancer stage
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
MRI of spine and thoracic inlet
Some stage IIB and III lung cancers are superior sulcus tumors. This type of
tumor starts at the top of the lung and easily grows into the chest wall. If this
tumor has grown next to your spine or nearby blood vessels, an MRI of your
spine and thoracic inlet is suggested. The thoracic inlet is the center of a ring
of bones at the top of the ribcage.
5.3 Biopsy tests
Cancer stage
Test name
I, II, IIIA
Bronchoscopy
I, II, and III
Mediastinal biopsy
IIIB tumors
Supraclavicular or scalene biopsy
IV with effusion (M1a)
Thoracentesis or pericardiocentesis ±
thoracoscopy
Bronchoscopy
Bronchoscopy is recommended for stages I, II, and IIIA tumors. However, your
doctors may wait to do a bronchoscopy until surgical treatment if they strongly
think your lung nodule is cancer. A bronchoscopy is very rarely done if there is
stage IV disease. Types of bronchoscopy are described in Part 3.1.
Mediastinal biopsy
The larger the tumor and the closer it is to the center of the chest, the more
likely the cancer has spread to mediastinal lymph nodes. A mediastinal biopsy is
recommended for stages IB, II, and III. This biopsy may not be needed if you have
a stage IA tumor that likely hasn’t spread to the mediastinal nodes. There is more
than one way to access mediastinal nodes. Examples are a mediastinoscopy,
EBUS-TBNA, and EUS-FNA. Read Part 3.2 for a description of these biopsies.
Definitions:
biopsy:
Removal of small
amounts of tissue or fluid to
be tested for disease
imaging test:
A test that
makes pictures of the
insides of the body
lymph node:
A small
group of disease-fighting
cells
metastases:
Cancer that
has spread from the first
site
nodule:
A small mass of
tissue
oxygen:
A gas that cells
need to live
radiation therapy:
The
use of radiation to treat
cancer
CT
= computed tomography
PET/CT
= positron emission
tomography/computed
tomography
Acronyms:
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