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

35 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 u ltra s ound-guided f ine- n eedle a spiration), a bronchoscope will be guided down your esophagus. Ultrasound is used to help find the right spot. A needle will then be inserted through your esophagus and into a lymph node to obtain a sample. Local anesthesia is used to prevent pain. Thoracentesis When cancer spreads into the fluid around the lungs, it can cause a buildup of fluid. This excess fluid is called pleural effusion. Fluid samples can be removed with thoracentesis. First, anesthesia will be injected into your skin. Then, a needle will be inserted between your ribs and into your chest cavity to remove fluid. The fluid will be assessed with a microscope to see if there are cancer cells. If cancer isn’t found by thoracentesis, a thoracoscopy may be done. See Figure 11 . Pericardiocentesis Pericardiocentesis is much like thoracentesis. Like the lungs, there is fluid around the heart. Excess fluid may build up if cancer invades it. This excess fluid is called pericardial effusion. Pericardiocentesis removes the excess fluid with a needle inserted through your chest wall. You will receive local anesthesia beforehand. Thoracoscopy This procedure can obtain samples of N2 and N3 lymph nodes as well as fluid from around the lungs and heart. It requires general anesthesia. A thoracoscope will be inserted through a cut between your ribs. Thoracoscopes work much like bronchoscopes allowing doctors to see any abnormal tissue. Samples can be collected with different types of tools. This surgery may cause some pain and swelling and will leave a small scar. This test is also called a VATS ( v ideo- a ssisted t horacoscopic s urgery). 4 Treatment planning Biopsy Figure 11 Thoracentesis Pleural effusion is the buildup of fluid around your lung. A thoracentesis is a procedure that removes some of the fluid. A needle will be inserted through your skin and into your lung. Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved. www.nucleusinc.com

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