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HomeAnswersSurgical Oncologylung cancerI have been suffering from lung cancer. Please help me interpret the reports.

How to diagnose lung cancer?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At October 1, 2023
Reviewed AtNovember 6, 2023

Patient's Query

Hi doctor,

Please help me understand the attached lung cancer diagnosis report.

Thanks.

Answered by Dr. Shivpal Saini

Hi,

Welcome to icliniq.com.

I understand your concern.

I had seen all these reports, and based on this, it is squamous cell carcinoma of the lung. Based on the CT (computed tomography) and bronchoscopy report, it looks like endobronchial and extra bronchial growth. CT report shows a hilar mass with a cut-off middle lobe bronchus and tumor along the bronchus intermedius. Nothing was mentioned about the mediastinal nodes. It is occluding the middle lobe bronchus on bronchoscopy, and the rest is fine. I want to see the CT image to ensure no significant mediastinal nodes. Also, if I consider him for upfront surgery, negative margins are possible. Further, I would like to proceed with PET (positron emission tomography), CECT (contrast-enhanced computed tomography), and MRI (magnetic resonance imaging) brain to rule out any metastatic disease. If both are normal, I would like to see a pulmonary function test (PFT). If PFT is adequate for surgical resection, then I would like to do invasive mediastinal staging by EBUS (endobronchial ultrasound) to rule out any N2 (non–small cell lung cancer) or N3 disease (non–small cell lung cancer). If no N2 or N3 disease exists, I would like to proceed with a mediastinoscopy.

Regarding the extent of surgical resection, I cannot comment without seeing imaging. Still, if positive, based on CT and bronchoscopy, the patient will require at least a middle lobectomy with bronchotomy and lower lobectomy. If single station N2 disease occurs at any point, then immunotherapy and reassessment for surgery is required. If multi-station N2, N3 disease, then definitive CTRT (cardiotoxicity of radiation therapy). And if negative margins are not possible based on the scan, we will proceed with the definitive CTRT. This is a provisional plan.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

I have attached the CT report. Does it depict anything new?

Thank you.

Answered by Dr. Shivpal Saini

Hi,

Welcome back to icliniq.com.

I understand your concern.

Thank you for the CT (computed tomography) report but actually I was asking for images of the CT scan. On the basis of the CT scan report it looks like single station N2 (non–small cell lung cancer) disease. Further I would like to proceed with PET (positron emission tomography), CECT (contrast-enhanced computed tomography), and MRI (magnetic resonance imaging) brain to rule out any metastatic disease. If both are normal then I would like to see a pulmonary function test (PFT) and if PFT is adequate for surgical resection then I would like to do invasive mediastinal staging by EBUS (endobronchial ultrasound) to rule out any N2 or N3 (non–small cell lung cancer) disease. And if it is single station N2, then neoadjuvant chemotherapy and immunotherapy followed by reassessment for surgery.

I hope this information will help you.

Thanks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shivpal Saini
Dr. Shivpal Saini

General Surgery

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