How Is Lung Cancer Diagnosed?
Learn about the various tests and procedures required for a lung cancer diagnosis.

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picture of doctor looking at lung x-ray How Is Lung Cancer Diagnosed?

If you have symptoms of lung cancer, your doctor will start by asking about your medical history. This will include questions about any known risk factors for lung cancer, such as a history of tobacco use. The doctor will also do a complete physical exam to check for swelling in your lymph nodes and liver.

If lung cancer is suspected, your doctor may order a series of diagnostic tests. Imaging tests are usually done first. These may include:

  • Chest x-ray. This is done to look for visual evidence of a lung tumor. If a spot or mass shows up on the x-ray, a CT scan of the chest may be done next.
  • CT scan. A CT scan uses an x-ray machine connected to a computer. The machine creates detailed images of structures in your chest, and it can show the size, shape and position of a lung tumor.

Imaging tests may show a lung mass that looks like cancer, but the diagnosis cannot be confirmed until a doctor called a pathologist examines the tissue or cells under the microscope. To get cells or tissue for diagnosis, one or more procedures may be done, such as:

  • Sputum cytology. The doctor will ask you to cough up mucous (sputum) from your lungs. This sample is then sent to a lab where the cells are checked to see if they are cancerous.
  • Bronchoscopy. The doctor passes a thin lighted instrument (bronchoscope) through your mouth or nose and into the lung. This allows the doctor to look at the lung and take tissue samples to send to the lab.
  • Fine needle aspiration. The doctor inserts a thin needle through the chest and into the tumor and uses the needle to remove a sample of tissue or fluid. A CT scan is done during the procedure to help the doctor see the tumor and guide the needle to it.
  • Mediastinoscopy. A surgeon makes a small incision at the top of the breastbone and inserts a thin lighted instrument. This lets the surgeon see the space between the lungs (mediastinum) and take tissue samples of nearby lymph nodes.
  • Thoracentesis. Sometimes a lung tumor can cause fluid to build up in the tissue surrounding the lung. For this procedure, the doctor uses a needle to remove a sample of the fluid to check it for cancer cells.
  • Thoracoscopy. The surgeon makes one to four small incisions in the chest or back and inserts a small, lighted instrument (thorascope). This lets the surgeon examine the lungs and chest wall and take tissue samples for biopsy.
By Louis Neipris, MD, Staff Writer
Created on 10/19/1999
Updated on 09/22/2010
  • Alberts WM. Diagnosis and management of lung cancer executive summary: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132;1S-19S.
  • National Cancer Institute. Lung cancer.
  • American Lung Association. Symptoms, diagnosis and treatment.
  • American Cancer Society. How is small cell lung cancer diagnosed?
Copyright © OptumHealth.
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