Small cell lung cancer is an aggressive cancer that forms in tissues of the lung and can spread to other parts of the body. Smoking is the major risk factor for development of this disease. Learn more about symptoms, diagnostic tests, and treatment options.
right side lung, side S2-S3 small cell carcinoma
Image by melvil
Overview
Lung Cancer
Image by Blausen Medical Communications, Inc./Wikimedia
Lung Cancer
By causing damage to the respiratory tract, it is not uncommon for lung cancer to cause sustained hemoptysis.
Image by Blausen Medical Communications, Inc./Wikimedia
Overview of Small Cell Lung Cancer
KEY POINTS
Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
There are two main types of small cell lung cancer.
Smoking is the major risk factor for small cell lung cancer.
Signs and symptoms of small cell lung cancer include coughing and shortness of breath.
Tests and procedures that examine the lungs are used to diagnose and stage small cell lung cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
For most patients with small cell lung cancer, current treatments do not cure the cancer.
Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
The lungs are a pair of cone-shaped breathing organs that are found in the chest. The lungs bring oxygen into the body when you breathe in and take out carbon dioxide when you breathe out. Each lung has sections called lobes. The left lung has two lobes. The right lung, which is slightly larger, has three. A thin membrane called the pleura surrounds the lungs. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also affected by lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.
There are two types of lung cancer: small cell lung cancer and non-small cell lung cancer.
There are two main types of small cell lung cancer.
These two types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:
Small cell carcinoma (oat cell cancer).
Combined small cell carcinoma.
Source: National Cancer Institute (NIH)
Additional Materials (33)
What is lung cancer? | Cancer Research UK
Video by Cancer Research UK/YouTube
Small cell lung cancer may respond to combination of immunotherapy and targeted therapy
Video by MD Anderson Cancer Center/YouTube
What is lung cancer? | Respiratory system diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Lung Cancer
Video by Health Television/YouTube
Healthy Lung and Lung Cancer
Secondhand smoke, also known as environmental tobacco smoke, causes approximately 3,400 lung cancer deaths and between 22,000-70,000 heart disease deaths in adult nonsmokers in the US per year. Lung cancer is the most common cause of cancer-related death in men and the second most common in women. It is no coincidence that over 90% of lung cancer patients are smokers. Normally, the little hairs (cilia) and mucus that line the respiratory track are effective at preventing damaging or abrasive materials from making it into the lungs. The lung on the left side of this image is healthy and has all its natural biological barriers intact. Tobacco smoke destroys the precious cilia so that these protective structures are no longer on the job. Harmful irritants enter the respiratory tract, triggering mucus production but without the cilia, mucus is not able to mobilize along the respiratory tract and is unable to leave the body. Piles of mucus containing trapped inhaled materials can lead to serious lung diseases including cancer. The lung pictured on the right side of the image has developed the hollowed out spaces characteristic of squamous cell carcinoma.
Image by TheVisualMD
Lung Cancer
Lung Cancer
Image by Open
Stage 1 and Stage 2 Lung Cancer
Video by Cleveland Clinic/YouTube
Asbestos Exposure Lung Cancer Survivor – Patrick Appert
Video by St. Luke's Health/YouTube
Understanding Lung Cancer - Jumo Health
Video by Jumo Health/YouTube
What is Lung Cancer?
Video by Mechanisms in Medicine/YouTube
What is Lung Cancer?
Video by Cleveland Clinic/YouTube
Small-Cell Lung Cancer: Future Directions in Care
Video by OncLiveTV/YouTube
Small Cell Lung Cancer Explained
Video by GO2 for Lung Cancer/YouTube
Battling Lung Cancer with Immunotherapy
Video by Johns Hopkins Medicine/YouTube
Immunotherapy: Moving beyond PD1 and PDL1 inhibitors
Video by ImedexCME/YouTube
EBUS guide for patients: bronchoscopy technique for chest abnormalities
Video by astrazeneca/YouTube
What's the difference between non-small cell lung cancer & small cell lung cancer? | Norton Cancer
Video by Norton Healthcare/YouTube
Combined Therapies for Small-Cell Lung Cancer
Video by NEJMvideo/YouTube
OPDIVO for Small Cell Lung Cancer
Video by Roper St. Francis Healthcare/YouTube
Treatment and Management of Small Cell Lung Cancer (SCLC)
Video by You and Lung Cancer/YouTube
Let’s talk about small-cell lung cancer - Laura's story
Video by Bupa/YouTube
Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)
Video by You and Lung Cancer/YouTube
Understanding Small Cell Lung Cancer
Video by You and Lung Cancer/YouTube
Basics of Small Cell Lung Cancer
Video by GRACE - Global Resource for Advancing Cancer Education/YouTube
The Spectrum of Outcomes for Small Cell Lung Cancer
Video by curetoday/YouTube
Living Beyond Small Cell Lung Cancer
Video by curetoday/YouTube
Research Update: Small Cell Lung Cancer
Video by Lung Cancer Foundation of America/YouTube
Lung Carcinoma (Lung cancer)
Video by Armando Hasudungan/YouTube
What Is Small Cell Lung Cancer? | Lung Foundation Australia
Video by Lung Foundation Australia/YouTube
Lung Cancers - Small Cell, Adenocarcinoma, and Large Cell Cancers
Video by USMLE pass/YouTube
Small Cell Lung Cancer (Small Cell Carcinoma) | USMLE Step 1 Mnemonic
Video by Pixorize/YouTube
Lung Cancer | The most COMPREHENSIVE Explanation
Video by Medicosis Perfectionalis/YouTube
Lung cancer types | Respiratory system diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
1:32
What is lung cancer? | Cancer Research UK
Cancer Research UK/YouTube
1:51
Small cell lung cancer may respond to combination of immunotherapy and targeted therapy
MD Anderson Cancer Center/YouTube
7:56
What is lung cancer? | Respiratory system diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
8:49
Lung Cancer
Health Television/YouTube
Healthy Lung and Lung Cancer
TheVisualMD
Lung Cancer
Open
2:23
Stage 1 and Stage 2 Lung Cancer
Cleveland Clinic/YouTube
2:05
Asbestos Exposure Lung Cancer Survivor – Patrick Appert
St. Luke's Health/YouTube
9:06
Understanding Lung Cancer - Jumo Health
Jumo Health/YouTube
3:26
What is Lung Cancer?
Mechanisms in Medicine/YouTube
2:41
What is Lung Cancer?
Cleveland Clinic/YouTube
3:00
Small-Cell Lung Cancer: Future Directions in Care
OncLiveTV/YouTube
2:02
Small Cell Lung Cancer Explained
GO2 for Lung Cancer/YouTube
3:29
Battling Lung Cancer with Immunotherapy
Johns Hopkins Medicine/YouTube
23:02
Immunotherapy: Moving beyond PD1 and PDL1 inhibitors
ImedexCME/YouTube
7:32
EBUS guide for patients: bronchoscopy technique for chest abnormalities
astrazeneca/YouTube
2:17
What's the difference between non-small cell lung cancer & small cell lung cancer? | Norton Cancer
Norton Healthcare/YouTube
1:58
Combined Therapies for Small-Cell Lung Cancer
NEJMvideo/YouTube
1:31
OPDIVO for Small Cell Lung Cancer
Roper St. Francis Healthcare/YouTube
3:13
Treatment and Management of Small Cell Lung Cancer (SCLC)
You and Lung Cancer/YouTube
2:05
Let’s talk about small-cell lung cancer - Laura's story
Bupa/YouTube
2:52
Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)
You and Lung Cancer/YouTube
5:10
Understanding Small Cell Lung Cancer
You and Lung Cancer/YouTube
4:55
Basics of Small Cell Lung Cancer
GRACE - Global Resource for Advancing Cancer Education/YouTube
5:10
The Spectrum of Outcomes for Small Cell Lung Cancer
curetoday/YouTube
5:11
Living Beyond Small Cell Lung Cancer
curetoday/YouTube
5:46
Research Update: Small Cell Lung Cancer
Lung Cancer Foundation of America/YouTube
13:33
Lung Carcinoma (Lung cancer)
Armando Hasudungan/YouTube
0:38
What Is Small Cell Lung Cancer? | Lung Foundation Australia
Lung Foundation Australia/YouTube
3:15
Lung Cancers - Small Cell, Adenocarcinoma, and Large Cell Cancers
USMLE pass/YouTube
5:52
Small Cell Lung Cancer (Small Cell Carcinoma) | USMLE Step 1 Mnemonic
Pixorize/YouTube
34:56
Lung Cancer | The most COMPREHENSIVE Explanation
Medicosis Perfectionalis/YouTube
5:45
Lung cancer types | Respiratory system diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
Risk Factors
Depiction of a person smoking and stages of Lung Cancer
Image by https://www.myupchar.com
Depiction of a person smoking and stages of Lung Cancer
Depiction of a person smoking and stages of Lung Cancer
Image by https://www.myupchar.com
Smoking Is the Major Risk Factor for Small Cell Lung Cancer
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for lung cancer.
Risk factors for lung cancer include the following:
Smoking cigarettes, pipes, or cigars, now or in the past. This is the most important risk factor for lung cancer. The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer.
Being exposed to secondhand smoke.
Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace.
Being exposed to radiation from any of the following:
Radiation therapy to the breast or chest.
Radon in the home or workplace.
Imaging tests such as CT scans.
Atomic bomb radiation.
Living where there is air pollution.
Having a family history of lung cancer.
Being infected with the human immunodeficiency virus (HIV).
Taking beta carotene supplements and being a heavy smoker.
Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
When smoking is combined with other risk factors, the risk of lung cancer is increased.
Source: National Cancer Institute (NCI)
Additional Materials (26)
Smoking and Exposed Respiratory System
Smoking and Exposed Respiratory System
Image by ThevisualMD
Smoking and Lung Cancer
64,300 cases of cancer are caused by smoking each year in the UK/ 2014
Image by Cancer Research UK / Wikimedia Commons
Quitting Smoking
Smoking is bad for anyone, of course, but it`s especially bad for people with prediabetes or diabetes. Scientists have known for many years that smokers with diabetes have higher blood sugar levels than nonsmokers with diabetes, but they haven`t understood why. Now, researchers at California State Polytechnic University in Pomona, California, have discovered a “smoking gun” that helps to explain why smoking is especially bad for people with diabetes. They found strong evidence that it`s the nicotine in tobacco that`s the main culprit in making symptoms of diabetes and the risk of developing complications far worse for smokers. Their study showed that nicotine causes blood A1C levels to rise by as much as 34%. And the higher the nicotine levels, the more A1C is produced. Smoking also constricts blood vessels and raises the level of inflammation throughout the body. Smoking is linked with insulin resistance. In fact, cigarette smokers are almost three times as likely to develop diabetes as people who have never smoked.For people who already have diabetes, smoking causes macrovascular complications (like heart attack and stroke) and microvascular complications (such as kidney disease, retinal disease, and foot problems) to occur sooner. Smoking increases risk of death for people with diabetes. Studies show that smoking shortens lives an average of 5-10 years, but there`s evidence that it shortens lifespan even more for people with diabetes. Quitting Smoking • Write down your reasons for quitting. Smoke cessation counselors find this a crucial step in successfully quitting. You must be clear on your goals and reasons for quitting. Writing them down in your own words personalizes and reinforces your objective. • Tell your doctor, friends and family that you want to quit. You will need their support and participation. Ask friends and family not to smoke or keep cigarettes near you. Let them know you may go through some emotional phases that won`t be easy for any of you on the way to a smoke-free life. • Make your home smoke-free. Insist that no one ever smoke inside, for the health of everyone who lives there. Quitters who live in smoke-free homes have fewer episodes of backsliding. It`s important, though, when quitting smoking, to take steps to avoid putting on weight, as weight gain creates health problems as well, especially for people who have diabetes.
Image by TheVisualMD
Healthy Cilia / Smoke-Damaged Cilia
Respiratory Cilia Damaged by Smoking
1) A close up view of healthy respiratory cilia, the hairlike structures that line the respiratory pathway. Healthy cilia move in a regular pattern to push foreign contaminants, bound in mucus, out toward the mouth and nose to be expelled from the body.
2) A close up view of damaged respiratory cilia, the hairlike structures that line the respiratory pathway. Unhealthy cilia are worn down and some are incapable of movement. They cannot beat in unison to push contaminants out of the respiratory system, as they do when healthy.
Interactive by TheVisualMD
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Quit Smoking: Countdown to Better Health
The health benefits of quitting smoking can help most of the major parts of your body: from your brain to your DNA. Learn the benefits of quitting from the first 12 hours to the next 15 years.
Interactive by TheVisualMD
Radon - The 2nd cause of lung cancer after smoking
Video by AssociationPulmonaireQc/YouTube
Me My Smoking and I
Video by Irish Cancer Society/YouTube
Health Benefits of Quitting Smoking
Video by American Lung Association/YouTube
Does Marijuana Cause Lung Cancer?
Video by NutritionFacts.org/YouTube
Radon Decay Product causes lung cancer
Video by National Radon Defense/YouTube
This browser does not support the video element.
Smoking Is Deadly
No matter how long you have been smoking or what health problems you face, quitting will improve your longevity and quality of life. Quitting will cut your risk of cancer, chronic obstructive pulmonary disease, heart attack, strokes and more. Many smokers give up the notion of quitting after a failed attempt or two. The difficulty of quitting is undeniable. But using the right tools and finding good support for the decision is what has propelled millions of former smokers through the perils of quitting to a life of better health and breathing easier.
Video by TheVisualMD
Effects of Smoking : How Does Smoking Cause Leukemia?
Video by ehowhealth/YouTube
This browser does not support the video element.
Dr. Benowitz on passive smoking and children
Dr. Benowitz on passive smoking and children
Video by TheVisualMD
This browser does not support the video element.
Smoking & Your Lungs
The first line of defense against tobacco toxins is the respiratory system. It takes a beating from cigarette smoke. Smokers are more likely to have respiratory infections, as well as chronic respiratory ailments and cancer throughout the body. Your body tries to push toxins out by building up extra mucus in the lungs. Cilia are hairlike projections lining the respiratory system which usually push mucus and invading toxins out of the airways. But smokers' cilia are shortened and damaged as a result of smoking. That's why smokers hack and cough to expel the mucus clogging their lungs.
Video by TheVisualMD
This browser does not support the video element.
Quitting is Hard, But You Can Do It!
Former smokers have overcome one of the toughest habits that humans can form. Many try and fail to quit many times before finally kicking cigarettes for good. Those people usually have a strong commitment to improving their health, as well as support from friends, family and medical professionals. Some use medications that help them manage their feelings of withdrawal or depression as they break the nicotine habit. Nearly all establish a non-smoking home and try to avoid spending too much time with smokers. Our experts will show you the best ways to tackle a smoking habit and break it for good.
Video by TheVisualMD
This browser does not support the video element.
Why Quitting Is Hard
The risks of smoking are clear, and often repeated. But one reason that quitting is so hard is that smoking is pleasurable to smokers. They feel alert, focused and fully engaged in the day once they have had the day's first smoke. Nicotine addiction is strong, especially in those who have started smoking as teens, because the longer they smoke, the more nicotine receptors develop in their body. The behavioral cues that signal smokers to light up are also better established in long-time smokers. Those who quit must overcome nicotine's powerful grip and change their daily routines—sometimes even their friends—in order to succeed. More than 47 million Americans have kicked tobacco, so far. They have worked diligently, with plenty of support, but they have done it.
Video by TheVisualMD
Stop Smoking
Damage to your respiratory, neurological and cardiovascular health from Smoking
Image by TheVisualMD
This browser does not support the video element.
Cardiovascular Continuum
Voyage into your body to see an amazing creation you're born with: the perfect cardiovascular system. A lifetime of poor health habits can destroy that system and lead to major medical problems and a shortened lifespan, but it doesn't have to be that way. You have the power to keep your body and mind healthy, strong, and alive. See how you can live longer and live better.
Video by TheVisualMD
This browser does not support the video element.
Are Light Cigarettes Better for You?
The notion that light cigarettes are less toxic and threatening than other cigarettes is one of Big Tobacco's sneakiest marketing tricks. It simply isn't true. So-called "light" cigarettes still contain scores of chemicals that poison your respiratory and blood stream. Inhaling these substances in smoke still speeds highly-addictive nicotine to your neurons, and wreaks havoc on your longs, no matter what name appears on the cigarette carton.
Video by TheVisualMD
This browser does not support the video element.
Dr. Make: Why quit now?
The physical and emotional discomfort of kicking the habit can overwhelm long-time smokers
Video by TheVisualMD
How Smoking Impacts Your Lung Health
Video by American Lung Association/YouTube
Quitting Smoking With Lung Cancer (Conditions A-Z)
Video by Healthguru/YouTube
Diagnosed with Lung Cancer and Still Smoking? (Conditions A-Z)
Video by Healthguru/YouTube
E-cigarettes linked to lung cancer in mice | NHS Behind the Headlines
Video by NHS/YouTube
This Is The Best Way To Quit Smoking
Video by Seeker/YouTube
What is lung cancer? | Respiratory system diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Smoking and Exposed Respiratory System
ThevisualMD
Smoking and Lung Cancer
Cancer Research UK / Wikimedia Commons
Quitting Smoking
TheVisualMD
Respiratory Cilia Damaged by Smoking
TheVisualMD
Quit Smoking: Countdown to Better Health
TheVisualMD
1:01
Radon - The 2nd cause of lung cancer after smoking
AssociationPulmonaireQc/YouTube
6:07
Me My Smoking and I
Irish Cancer Society/YouTube
1:27
Health Benefits of Quitting Smoking
American Lung Association/YouTube
4:13
Does Marijuana Cause Lung Cancer?
NutritionFacts.org/YouTube
1:53
Radon Decay Product causes lung cancer
National Radon Defense/YouTube
3:07
Smoking Is Deadly
TheVisualMD
1:14
Effects of Smoking : How Does Smoking Cause Leukemia?
ehowhealth/YouTube
1:10
Dr. Benowitz on passive smoking and children
TheVisualMD
1:33
Smoking & Your Lungs
TheVisualMD
2:45
Quitting is Hard, But You Can Do It!
TheVisualMD
2:46
Why Quitting Is Hard
TheVisualMD
Stop Smoking
TheVisualMD
3:37
Cardiovascular Continuum
TheVisualMD
0:45
Are Light Cigarettes Better for You?
TheVisualMD
0:42
Dr. Make: Why quit now?
TheVisualMD
6:47
How Smoking Impacts Your Lung Health
American Lung Association/YouTube
2:15
Quitting Smoking With Lung Cancer (Conditions A-Z)
Healthguru/YouTube
0:56
Diagnosed with Lung Cancer and Still Smoking? (Conditions A-Z)
Healthguru/YouTube
1:19
E-cigarettes linked to lung cancer in mice | NHS Behind the Headlines
NHS/YouTube
4:09
This Is The Best Way To Quit Smoking
Seeker/YouTube
7:56
What is lung cancer? | Respiratory system diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
Signs & Symptoms
small cell lung cancer
Image by melvil
small cell lung cancer
right side lung, side S2-S3 small cell carcinoma
Image by melvil
Signs and Symptoms of Small Cell Lung Cancer
Signs & Symptoms
These and other signs and symptoms may be caused by small cell lung cancer or by other conditions. Check with your doctor if you have any of the following:
Chest discomfort or pain.
A cough that doesn’t go away or gets worse over time.
Trouble breathing.
Wheezing.
Blood in sputum (mucus coughed up from the lungs).
Hoarseness.
Trouble swallowing.
Loss of appetite.
Weight loss for no known reason.
Feeling very tired.
Swelling in the face and/or veins in the neck.
Source: National Cancer Institute (NIH)
Additional Materials (7)
Symptoms of lung cancer
Video by Cancer Research UK/YouTube
What Are the Signs and Symptoms of Lung Cancer?
Video by Roswell Park Comprehensive Cancer Center/YouTube
Sensitive content
This media may include sensitive content
Option for stage 2Bb lung cancer
One option for stage IIB lung cancer, with T2b; but if tumor is within 2 cm of the carina, this is stage 3
Image by Cancer Research UK / Wikimedia Commons
Histopathology Lung--Small cell carcinoma
Video by WashingtonDeceit/YouTube
Understanding Lung Cancer Survival Rate
Video by Roswell Park Comprehensive Cancer Center/YouTube
Lung cancer complications | Respiratory system diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Frequently Searched Questions | Lung Cancer
Video by Roswell Park Comprehensive Cancer Center/YouTube
0:47
Symptoms of lung cancer
Cancer Research UK/YouTube
2:34
What Are the Signs and Symptoms of Lung Cancer?
Roswell Park Comprehensive Cancer Center/YouTube
Sensitive content
This media may include sensitive content
Option for stage 2Bb lung cancer
Cancer Research UK / Wikimedia Commons
4:52
Histopathology Lung--Small cell carcinoma
WashingtonDeceit/YouTube
2:29
Understanding Lung Cancer Survival Rate
Roswell Park Comprehensive Cancer Center/YouTube
8:02
Lung cancer complications | Respiratory system diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
7:52
Frequently Searched Questions | Lung Cancer
Roswell Park Comprehensive Cancer Center/YouTube
Diagnosis
Lung biopsy guided by computertomography: Lung cancer
Image by Hellerhoff
Lung biopsy guided by computertomography: Lung cancer
Lung biopsy guided by computertomography: Lung cancer
Image by Hellerhoff
Diagnosis of Small Cell Lung Cancer
In addition to asking about your personal and family health history and doing a physical exam, your doctor may perform the following tests and procedures:
Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Sputum cytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The different ways a biopsy can be done include the following:
Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluid from the lung, using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to find the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.
Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.
Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.
Mediastinoscopy: A surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.
Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
Source: National Cancer Institute (NIH)
Additional Materials (15)
Diagram showing how you have internal radiotherapy for lung cancer
Diagram showing how you have internal radiotherapy for lung cancer.
Image by Cancer Research UK/Wikimedia
Small cell carcinoma - CT scan
Small cell carcinoma - CT scan
Image by Yale Rosen from USA/Wikimedia
Puncture under scanner of a tumor of the right pulmonary apex.
Puncture under scanner of a tumor of the right pulmonary apex.
Image by Aspérule
Sensitive content
This media may include sensitive content
What To Expect Before, During and After a Bronchoscopy
Diagram showing a bronchoscopy.
Image by Cancer Research UK / Wikimedia Commons
How to Test for Lung Cancer Biomarkers
Video by American Lung Association/YouTube
Lung cancer diagnosis | Respiratory system diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Lung Cancer Surgery for Diagnosis and Treatment
Video by HenryFordTV/YouTube
Lung Cancer Screening: Early Detection for Smokers
Video by uvahealth/YouTube
Lung Cancer Screening | Q&A
Video by Johns Hopkins Medicine/YouTube
How is Lung Cancer Diagnosed?
Video by HenryFordTV/YouTube
What is a lung cancer biomarker?
Video by American Lung Association/YouTube
Lung Cancer Screening - Mayo Clinic
Video by Mayo Clinic/YouTube
Low Dose CT Scans to Look for Lung Cancer
Video by Lee Health/YouTube
Bronchoscopy & Lung Nodule Biopsy | Fox Chase Cancer Center
Video by Fox Chase Cancer Center/YouTube
Lung Cancer Screening: The Life-saving CT Scan
Video by RAYUS Radiology™/YouTube
Diagram showing how you have internal radiotherapy for lung cancer
Cancer Research UK/Wikimedia
Small cell carcinoma - CT scan
Yale Rosen from USA/Wikimedia
Puncture under scanner of a tumor of the right pulmonary apex.
Aspérule
Sensitive content
This media may include sensitive content
What To Expect Before, During and After a Bronchoscopy
Cancer Research UK / Wikimedia Commons
2:16
How to Test for Lung Cancer Biomarkers
American Lung Association/YouTube
5:52
Lung cancer diagnosis | Respiratory system diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
1:09
Lung Cancer Surgery for Diagnosis and Treatment
HenryFordTV/YouTube
2:17
Lung Cancer Screening: Early Detection for Smokers
uvahealth/YouTube
3:20
Lung Cancer Screening | Q&A
Johns Hopkins Medicine/YouTube
1:01
How is Lung Cancer Diagnosed?
HenryFordTV/YouTube
2:01
What is a lung cancer biomarker?
American Lung Association/YouTube
2:48
Lung Cancer Screening - Mayo Clinic
Mayo Clinic/YouTube
1:44
Low Dose CT Scans to Look for Lung Cancer
Lee Health/YouTube
4:25
Bronchoscopy & Lung Nodule Biopsy | Fox Chase Cancer Center
Fox Chase Cancer Center/YouTube
3:09
Lung Cancer Screening: The Life-saving CT Scan
RAYUS Radiology™/YouTube
Low-Dose Computed Tomography
Low-Dose Computed Tomography
Also called: LDCT, Low-Dose CT Scan, Lung Cancer Screening with Low-Dose CT
Lung cancer screening with low-dose computed tomography is recommended only for adults who have no symptoms but are at high risk for developing the disease because of their smoking history and age. In this test, an X-ray machine scans the body and uses low doses of radiation to make detailed pictures of the lungs.
Low-Dose Computed Tomography
Also called: LDCT, Low-Dose CT Scan, Lung Cancer Screening with Low-Dose CT
Lung cancer screening with low-dose computed tomography is recommended only for adults who have no symptoms but are at high risk for developing the disease because of their smoking history and age. In this test, an X-ray machine scans the body and uses low doses of radiation to make detailed pictures of the lungs.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means nothing abnormal was seen on the scan. Ask your care team when and if you should repeat the scan based on your health and history. False-negative test results can occur, meaning the scan may appear to be normal even though lung cancer is present.
Related conditions
Who Should Be Screened for Lung Cancer? | CDC [accessed on Jan 07, 2019]
Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG-00439N) [accessed on Jan 07, 2019]
Lung Cancer Screening With Low-Dose CT (LDCT) FAQs [accessed on Jan 07, 2019]
Lung Cancer Screening [accessed on Jan 07, 2019]
PDQ® Screening and Prevention Editorial Board. PDQ Lung Cancer Screening. Bethesda, MD: National Cancer Institute. [accessed on Jan 07, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Chest X-Ray Test
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
X rays are electromagnetic waves. They use ionizing radiation to create pictures of the inside of your body. A chest x ray takes pictures of the inside of your chest. The different tissues in your chest absorb different amounts of radiation. Your ribs and spine are bony and absorb radiation well. They normally appear light on a chest x ray. Your lungs, which are filled with air, normally appear dark.
Related conditions
A chest x ray is a painless, noninvasive test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. "Noninvasive" means that no surgery is done and no instruments are inserted into your body. This test is done to find the cause of symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), and fever.
Chest x rays help doctors diagnose conditions such as pneumonia (nu-MO-ne-ah), heart failure, lung cancer, lung tissue scarring, and sarcoidosis (sar-koy-DO-sis). Doctors also may use chest x rays to see how well treatments for certain conditions are working. Also, doctors often use chest x rays before surgery to look at the structures in the chest.
Chest x rays are the most common x-ray test used to diagnose health problems.
Doctors may recommend chest x rays for people who have symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), or fever. The test can help find the cause of these symptoms.
Chest x rays look for conditions such as pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis. The test also is used to check how well treatments for certain conditions are working.
Chest x rays also are used to evaluate people who test positive for tuberculosis (tu-ber-kyu-LO-sis) exposure on skin tests.
Sometimes, doctors recommend more chest x rays within hours, days, or months of an earlier chest x ray. This allows them to follow up on a condition.
People who are having certain types of surgery also may need chest x rays. Doctors often use the test before surgery to look at the structures inside the chest.
Depending on your doctor's request, you'll stand, sit, or lie for the chest x ray. The technician will help position you correctly. He or she may cover you with a heavy lead apron to protect certain parts of your body from the radiation.
The x-ray equipment usually consists of two parts. One part, a box-like machine, holds the x-ray film or a special plate that records the picture digitally. You'll sit or stand next to this machine. The second part is the x-ray tube, which is located about 6 feet away.
Before the pictures are taken, the technician will walk behind a wall or into the next room to turn on the x-ray machine. This helps reduce his or her exposure to the radiation.
Usually, two views of the chest are taken. The first is a view from the back. The second is a view from the side.
For a view from the back, you'll sit or stand so that your chest rests against the image plate. The x-ray tube will be behind you. For the side view, you'll turn to your side and raise your arms above your head.
If you need to lie down for the test, you'll lie on a table that contains the x-ray film or plate. The x-ray tube will be over the table.
You'll need to hold very still while the pictures are taken. The technician may ask you to hold your breath for a few seconds. These steps help prevent a blurry picture.
Although the test is painless, you may feel some discomfort from the coolness of the exam room and the x-ray plate. If you have arthritis or injuries to the chest wall, shoulders, or arms, you may feel discomfort holding a position during the test. The technician may be able to help you find a more comfortable position.
When the test is done, you'll need to wait while the technician checks the quality of the x-ray pictures. He or she needs to make sure that the pictures are good enough for the doctor to use.
You don't have to do anything special to prepare for a chest x ray. However, you may want to wear a shirt that's easy to take off. Before the test, you'll be asked to undress from the waist up and wear a gown.
You also may want to avoid wearing jewelry and other metal objects. You'll be asked to take off any jewelry, eyeglasses, and metal objects that might interfere with the x-ray picture. Let the x-ray technician (a person specially trained to do x-ray tests) know if you have any body piercings on your chest.
Let your doctor know if you're pregnant or may be pregnant. In general, women should avoid all x-ray tests during pregnancy. Sometimes, though, having an x ray is important to the health of the mother and fetus. If an x ray is needed, the technician will take extra steps to protect the fetus from radiation.
Chest x rays have few risks. The amount of radiation used in a chest x ray is very small. A lead apron may be used to protect certain parts of your body from the radiation.
The test gives out a radiation dose similar to the amount of radiation you're naturally exposed to over 10 days.
Chest x rays show the structures in and around the chest. The test is used to look for and track conditions of the heart, lungs, bones, and chest cavity. For example, chest x-ray pictures may show signs of pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis.
Chest x rays do have limits. They only show conditions that change the size of tissues in the chest or how the tissues absorb radiation. Also, chest x rays create two-dimensional pictures. This means that denser structures, like bone or the heart, may hide some signs of disease. Very small areas of cancer and blood clots in the lungs usually don't show up on chest x rays.
For these reasons, your doctor may recommend other tests to confirm a diagnosis.
https://www.nhlbi.nih.gov/health-topics/chest-x-ray [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003804.htm [accessed on Aug 25, 2021]
https://www.radiologyinfo.org/en/info/chestrad [accessed on Aug 25, 2021]
https://www.emedicinehealth.com/chest_x-ray/article_em.htm [accessed on Aug 25, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
Chest X-Ray Basics in 5 min
Video by Nick Smith/YouTube
How X-rays see through your skin - Ge Wang
Video by TED-Ed/YouTube
What causes Acute respiratory distress syndrome (ARDS) and who is at Risk?
Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
Image by Altaf Gauhar Haji, Shekhar Sharma, DK Vijaykumar and Jerry Paul
Tuberculosis X-ray
An anteroposterior X-ray of a patient diagnosed with advanced bilateral pulmonary tuberculosis. This AP X-ray of the chest reveals the presence of bilateral pulmonary infiltrate (white triangles), and caving forma.
Image by CDC / Der Lange
Respiratory Syncytial Virus
This highly-magnified, 1981 transmission electron microscopic (TEM) image, reveals some of the morphologic traits exhibited by a human respiratory syncytial virus (RSV). The virion is variable in shape, and size, with an average diameter between 120-300nm. RSV is the most common cause of bronchiolitis and pneumonia among infants and children, under 1-year of age.
Image by CDC/ E. L. Palmer
Q Fever Pneumonia X-ray
Combination of two x-rays (A) normal chest x-ray (B) x-ray documenting Q fever pneumonia.
Image by US Gov
Chest X Ray
A Lateral Chest X-Ray with the heart shadow outlined.
Image by US Army
Projectional radiography
Image relating focal spot size to geometric unsharpness in projectional radiography.
Image by Source images by Blausen Medical and LadyofHats (Mariana Ruiz Villarreal) Derivative by Mikael Haggstrom
Chest Radiograph
Chest X-Ray : Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
X-ray of Healthy Lung
This image shows an x-ray of healthy lungs.
Image by TheVisualMD
Cancer screening
Cancer Imaging: X-Rays : Chest X-rays can be used to show the presence of tumors, as for lung cancer, but they may also indicate problems associated with cancer. An X-ray may produce images suggestive of fluid accumulation, masses, or enlarged lymph nodes.
Image by TheVisualMD
Lung Cancer
Chest X-ray (Cancer): This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute
Chest X Ray
Mediastinal structures on a chest radiograph.
Image by Mikael Haggstrom, from source images by ZooFari, Stillwaterising and Gray's Anatomy creators
CT Chest Scan of Pleura effusion
CT scan of chest showing loculated pleural effusion in left side. Some thickening of pleura is also noted. From my personal collection. Permission obtained from patient.
Image by Drriad
Chest X-ray (Cancer)
This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute / Unknown Photographer
This browser does not support the video element.
CT Scans (VIDEO)
This video shows how modern science of scanning can expose the health condition of the patient. The video starts with a patient undergoing CT scanning, an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Visible are the heart, lungs, and arteries of a patient.
Video by TheVisualMD
Chest X-Ray
Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings
Arrows indicate costophrenic angles
Image by US Army
Gallstones
Gallstones as seen on plain x-ray.
Image by James Heilman, MD
Hemoptysis x-ray
Hemoptysis can be discovered with the help of radiology.
Image by Aidan Jones from Oxford, U.K.
X-ray of Lung with Pulmonary Edema
Within the lungs, the main airways (bronchi) branch off into smaller passageways, the smallest of which are called bronchioles. At the end of the bronchioles are tiny air sacs (alveoli). Pulmonary edema is a condition caused when excess fluid collects in these air sacs, making it difficult to breathe. Fluid in the lungs can be caused by pneumonia, acute respiratory distress and other conditions, but in most cases, the cause of pulmonary edema is heart problems (when a damaged heart can't pump enough blood and fluid leaks into the lungs).
Image by TheVisualMD
What To Expect During and After Implantable Cardioverter Defibrillator Surgery
A normal chest X-ray after placement of an ICD, showing the ICD generator in the upper left chest and the ICD lead in the right ventricle of the heart. Note the 2 opaque coils along the ICD lead.
Image by Gregory Marcus, MD, MAS, FACC
This browser does not support the video element.
Chest X-ray: NCI B-roll [video]
NCI B-roll of a patient receiving a Chest X-ray. This video is silent.
Video by National Cancer Institute (NCI)
X-Ray of Aneurysm within Chest frontal view
Most aneurysms are detected in the course of an exam, such as a physical exam or a chest X-ray, being performed for a different reason.
Image by TheVisualMD
Pleural Effusion: Tests
Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.
Image by CDC InvictaHOG
Coccidioidomycosis
This anteroposterior (AP) chest x-ray revealed pulmonary changes indicative of pulmonary fibrosis in a case of coccidioidomycosis, caused by fungal organisms of the genus, Coccidioides. Because these changes also resemble those seen in other lung infections including tuberculosis, the findings uncovered with a chest x-ray needs to be coupled with serologic testing, as well as possible tissue biopsy. The degree of fibrotic changes, indicative of scarring found on x-ray, can be directly correlated to the severity of the fungal infection.
Image by CDC/ Dr. Lucille K. Georg
How Is Acute respiratory distress syndrome (ARDS) Diagnosed?
Chest X-Ray: Acute respiratory distress syndrome on plain Xray
Image by James Heilman, MD
How Are Asbestos-Related Lung Diseases Diagnosed?
Early Asbestosis in a Retired Pipe Fitter : Chest X-ray in asbestosis shows plaques above diaphragm
Image by Clinical Cases
Aspergillosis
This was a photomicrograph of a lung tissue specimen, harvested from a caged, sulfur-crested cockatoo, that depicted some of the histopathologic changes that had been caused by the fungal organism, Aspergillus fumigatus, in a case of avian pulmonary aspergillosis. Here, you are able see how the periodic acid-Schiff (PAS) stain, revealed A. fumigatus ultrastructural morphology including conidial heads and mycelium.
Image by CDC/ Dr. William Kaplan
Pleural Effusion - Defined
A large left sided pleural effusion as seen on an upright chest X-ray
Image by Drriad
Pleural Effusion: Tests
A large left sided pleural effusion as seen on an upright chest X-ray
Image by James Heilman MD
Breast implants
Chest X-ray showing breast implants
Image by James Heilman
Living With Idiopathic Pulmonary Fibrosis
No cure is available for idiopathic pulmonary fibrosis (IPF) yet. Your symptoms may get worse over time. As your symptoms worsen, you may not be able to do many of the things that you did before you had IPF.
However, lifestyle changes and ongoing care can help you manage the disease.
If you're still smoking, the most important thing you can do is quit. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Ask family members and friends not to smoke in front of you or in your home, car, or workplace.
Image by Drriad
Symptoms and Spread of SARS (Severe acute respiratory syndrome)
A chest x-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS.
Image by CDC
Chilaiditi syndrome
Chest X-ray showing obvious Chilaiditi's sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm (left side of the image).
Piper's Sign: In days gone by the lateral chest x-ray (demonstrating greater opacity in the aortic arch and descending aorta than the thoracic spine) gave an indication to the degree of calcified plaque burden a patient had. This has been known as Piper's sign and can often be seen in elderly persons particularly those with concomitant osteoporosis.
Image by U4077905
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Image by Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Image by Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Fungal Parasites and Pathogens
(a) Ringworm presents as a red ring on skin; (b) Trichophyton violaceum, shown in this bright field light micrograph, causes superficial mycoses on the scalp; (c) Histoplasma capsulatum is an ascomycete that infects airways and causes symptoms similar to influenza. (credit a: modification of work by Dr. Lucille K. Georg, CDC; credit b: modification of work by Dr. Lucille K. Georg, CDC; credit c: modification of work by M. Renz, CDC; scale-bar data from Matt Russell)
Image by CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
Pneumocystis jirovecii is the causative agent of Pneumocystis pneumonia (PCP), one of the most frequent and severe opportunistic infections in immunocompromised patients. Pneumocystis organisms represent a large group of species of atypical fungi with universal distribution and pulmonary tropism, and each species has a strong specificity for a given mammalian host species.
Image by CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Chest X-ray PA inverted and enhanced
Image by Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
PA view Chest X-Ray of Canadian dollar coin in esophagus of child. Released per permission of mother.
Image by Samir (talk)
Chest X Ray
Structures shown: Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings. Arrows indicate costophrenic angles
Image by US Army
Thoracic diaphragm
X-ray of chest, showing top of diaphragm.
Image by OpenStax College
Chest X Ray
Roentgenogram or Medical X-ray image. May not be to scale.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Mikael Häggström
Fungal Parasites and Pathogens
CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist.
7:02
Reading a chest X-ray
Osmosis/YouTube
Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
Altaf Gauhar Haji, Shekhar Sharma, DK Vijaykumar and Jerry Paul
PET Scan
PET Scan
Also called: PET Imaging, Positron Emission Tomography, Positron Emission Testing, PET Scan
A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.
PET Scan
Also called: PET Imaging, Positron Emission Tomography, Positron Emission Testing, PET Scan
A PET scan is an imaging test that uses a radioactive substance (tracer) to check for changes in chemical activity in the body. This activity may be a sign of cancer, heart disease, or a brain disorder.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
There are no problems detected in the size, shape, or function of the organ being scanned. There are no areas in which the tracer has abnormally collected.
Related conditions
A PET (positron emission tomography) scan is a nuclear imaging test that looks at how well your tissues and organs are working. It also checks for signs of cancer. For the scan, you will get an injection of a small amount of a tracer, which is a safe radioactive substance.
The tracer settles in areas of your body that have high levels of chemical activity. This activity can be a sign of cancer or other diseases. The tracer can also help measure blood flow, oxygen use, and changes in the metabolism of a particular tissue or organ. Metabolism is the process your body uses to make energy from the food you eat.
Chemical changes in your body can show up before you even have symptoms of a disease. Since a PET scan can see how your organs are working in real-time, it can find signs of disease at an early stage, often before the disease can be seen on other imaging tests.
Other names: positron emission tomography
A PET scan is most often used to:
Diagnose or monitor certain cancers, including breast, thyroid, and lung cancers
Find out how well your heart muscle is working
Check blood flow to your heart
Check for signs of certain brain disorders, such as Parkinson's disease, Huntington's disease, Alzheimer's disease, and other types of dementia
A PET scan is often done along with a CT scan, a type of x-ray that takes a series of pictures as it rotates around you.
You may need a PET scan to find out if you have cancer. If you've already been diagnosed with cancer, you may need this test to see if your cancer treatment is working.
A PET scan also helps diagnose and monitor heart and brain diseases. So you may need this test if you:
Have a family history of heart disease.
Are being treated for heart disease. This test can show if the treatment is working.
Have symptoms of a brain disease, such as tremors, memory problems, and/or seizures.
Before the scan, you will change into a hospital gown. You may be asked to empty your bladder. During the scan:
A health care provider will inject the radioactive tracer into your vein through an intravenous (IV) line. The tracer sends out a form of energy called gamma rays. The scanner picks up the rays to create images of the inside of your body.
You will need to wait for your body to absorb the tracer, which takes 45 to 60 minutes.
You will then lie on a narrow, padded table, which will slide into a large, donut-shaped scanner.
The scanner will move slowly across your body to capture images. As this happens, you will need to be very still for about 30 minutes.
You will hear clicking or buzzing noises as the images are taken.
The scanner will send images to a computer monitor for your provider to review.
Your provider will then remove the IV line.
The test takes about two hours to complete, including the time you wait for the tracer to be absorbed by your body.
Talk to your provider about how to prepare for the test.
You may be asked to fast (not eat or drink) for four to six hours before the test.
You may be asked to avoid tobacco products and food or drinks with caffeine or alcohol for 24 hours before the test.
If you have diabetes and use insulin, you may need to change the timing of your regular dose. Your provider will give you specific instructions about adjusting your insulin since people with diabetes may not absorb the sugar in the tracer. This may affect the results of your scan.
You may need to stop taking other medicines or supplements before the test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to.
Also, tell your provider if you have claustrophobia (fear of enclosed spaces). Your provider may decide to give you a medicine to help you relax during the test.
There is very little exposure to radiation in a PET scan. Only a small amount of radioactive substance is used, and it will leave your body through your urine and stool (poop) within 2 to 10 hours. Drink more water after the test to help remove the remaining tracer from your body.
While radiation exposure in a PET scan is safe for most adults, it can be harmful to a developing baby. So be sure to tell your provider if you are pregnant or think you may be pregnant. Also, tell your provider if you are breastfeeding, since the tracer may contaminate your breast milk.
Allergic reactions to the tracer are rare and usually mild.
Depending on which part of the body was being scanned, your results may show signs of:
Cancer. Cancer cells show up as bright spots on a PET scan.
Heart disease. The scan can show decreased blood flow to the heart.
A brain disorder. The scan may show changes in certain brain chemicals that can be a sign of a disease.
Some cancers don’t show up on a PET scan, so your provider may order additional tests based on your symptoms and medical history. If you also had a CT scan, your provider will review the results of the two scans to help make a diagnosis.
If you have questions about your results, talk to your provider.
Your PET scan results will be looked at by a radiologist, a doctor who specializes in diagnosing and treating medical conditions using imaging technologies. They will share the results with your provider.
https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007341.htm [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007342.htm [accessed on Jul 27, 2021]
https://medlineplus.gov/ency/article/007343.htm [accessed on Jul 27, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (23)
What is it Like to Have a PET Scan? | Cancer Research UK
Video by Cancer Research UK/YouTube
PET Scan in 3 views
PET Scan in 3 views
PET Scan in 3 views
1
2
3
PET Scan in 3 views
PET Scan in 3 views
Interactive by TheVisualMD
PET/CT
CT
PET
1
2
3
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
PET scans can often detect a tumor that can't be seen on CT scans or regular X-rays. Cancer tumors grow rapidly and so actively metabolize glucose. In a PET scan, the patient is injected with glucose containing a radioactive tracer. The PET scan image shows areas of the body that utilize the glucose. The brain, heart, and bladder all metabolize glucose and appear black in the image, along with any cancer tumors that are present.
Interactive by TheVisualMD
How Does a PET Scan Work?
Video by NIBIB gov/YouTube
UCSF Radiology: How does a PET scan help with cancer imaging?
Video by UCSF Imaging/YouTube
Your PET/CT scan at University College Hospital
Video by University College London Hospitals NHS Foundation Trust/YouTube
How X-rays see through your skin - Ge Wang
Video by TED-Ed/YouTube
PET Scans and CAT Scans
Video by Lee Health/YouTube
Having a PET-CT scan
Video by Design Science/YouTube
How does a PET scan work?
Video by Imperial College London/YouTube
Patient exercises
EKG monitoring
Inject radiotracer
Scanning with stress
Patient rests
Inject radiotracer again
1
2
3
4
5
6
Myocardial perfusion scan
Myocardial perfusion imaging is a test that uses a low dose of a radioactive agent to evaluate the blood flow and function of the heart. This scan is done in conjunction with a cardiac stress test a diagnostic test in which a person walks on a treadmill or pedals (a stationary bicycle) while hooked up to equipment that monitors the heart. The test monitors heart rate breathing blood pressure electrical activity (on an electrocardiogram) and the person's level of tiredness. It shows if the heart's blood supply is sufficient and if the heart rhythm is normal. A stress test can detect the following problems:
- Abnormal changes in heart rate or blood pressure
- Symptoms such as shortness of breath or chest pain
- Abnormal changes in the heart's rhythm or electrical activity
Interactive by TheVisualMD
Testing for bowel cancer
Video by Cancer Research UK/YouTube
MRI Animation
Video by Blausen Medical Corporate/YouTube
Carcinogenesis head and neck short version only animation
Video by Amsterdam UMC/YouTube
Head and Neck Cancer
Video by Robert Miller/YouTube
What are the Risk Factors and Symptoms of Head and Neck Cancers? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Introduction to Head and Neck Cancer | Memorial Sloan Kettering
Video by Memorial Sloan Kettering/YouTube
Throat Cancer
Video by Michigan Medicine/YouTube
Rush Radiosurgery: Head and Neck Cancer Radiation
Video by Rush Radiosurgery/YouTube
Treating the head and neck - Radiotherapy and its physics (3/15)
Video by OpenLearn from The Open University/YouTube
Nutrition Video for Head & Neck Cancer
Video by Stanford Health Care/YouTube
Throat Cancer Largely Due to Smoking And Drinking, Studies Show
Video by VOA News/YouTube
What is nuclear medicine? An illustrated introduction
Video by navalorama/YouTube
3:13
What is it Like to Have a PET Scan? | Cancer Research UK
Cancer Research UK/YouTube
PET Scan in 3 views
TheVisualMD
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
TheVisualMD
1:33
How Does a PET Scan Work?
NIBIB gov/YouTube
1:30
UCSF Radiology: How does a PET scan help with cancer imaging?
UCSF Imaging/YouTube
3:31
Your PET/CT scan at University College Hospital
University College London Hospitals NHS Foundation Trust/YouTube
4:42
How X-rays see through your skin - Ge Wang
TED-Ed/YouTube
1:37
PET Scans and CAT Scans
Lee Health/YouTube
5:17
Having a PET-CT scan
Design Science/YouTube
4:25
How does a PET scan work?
Imperial College London/YouTube
Myocardial perfusion scan
TheVisualMD
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
0:36
MRI Animation
Blausen Medical Corporate/YouTube
4:03
Carcinogenesis head and neck short version only animation
Amsterdam UMC/YouTube
7:27
Head and Neck Cancer
Robert Miller/YouTube
2:35
What are the Risk Factors and Symptoms of Head and Neck Cancers? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
18:04
Introduction to Head and Neck Cancer | Memorial Sloan Kettering
Memorial Sloan Kettering/YouTube
6:01
Throat Cancer
Michigan Medicine/YouTube
1:13
Rush Radiosurgery: Head and Neck Cancer Radiation
Rush Radiosurgery/YouTube
1:57
Treating the head and neck - Radiotherapy and its physics (3/15)
OpenLearn from The Open University/YouTube
4:25
Nutrition Video for Head & Neck Cancer
Stanford Health Care/YouTube
2:39
Throat Cancer Largely Due to Smoking And Drinking, Studies Show
VOA News/YouTube
3:02
What is nuclear medicine? An illustrated introduction
navalorama/YouTube
Sputum Culture
Sputum Culture
Also called: Sputum Cytology, Deep Cough Sputum, Respiratory Culture, Sputum Color, Sputum Culture
A sputum culture is a test that helps diagnose infections of the lungs or airways. Sputum is a thick mucus made in your lungs. It is not the same as spit or saliva. You may cough up sputum if you have an infection or chronic illness of the respiratory system.
Sputum Culture
Also called: Sputum Cytology, Deep Cough Sputum, Respiratory Culture, Sputum Color, Sputum Culture
A sputum culture is a test that helps diagnose infections of the lungs or airways. Sputum is a thick mucus made in your lungs. It is not the same as spit or saliva. You may cough up sputum if you have an infection or chronic illness of the respiratory system.
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Use the slider below to see how your results affect your
health.
Your result is Clear.
Sputum is naturally clear. However, large amounts of clear sputum may be a sign of lung disease.
Related conditions
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Use the slider below to see how your results affect your
health.
Your result is Negative.
If your results were normal, it means no harmful bacteria or fungi were found. A normal sputum sample result is negative for malignancy.
Related conditions
A sputum culture is a test that checks for bacteria or another type of germ that may be causing a respiratory tract infection (an infection in your lungs or airways). Sputum, also known as phlegm, is a thick type of mucus made in your lungs. If you have an infection or chronic illness affecting the lungs or airways, sputum can settle in your lungs, and you may also cough it up.
Sputum is not the same as spit or saliva. Sputum contains cells from your immune system that help fight bacteria, fungi, or other foreign substances in your lungs or airways. The thickness of sputum helps trap the foreign material. This allows cilia (tiny hairs) in the airways to push it through the mouth and be coughed out.
Sputum can be one of several different colors. The colors can help identify the type of infection you may have or check if a chronic illness has become worse. This helps your health care provider determine the best treatment. Sputum colors can include:
Clear. This usually means you don't have an infection, but large amounts of clear sputum may be a sign of lung disease.
White or gray. This may also be normal, but increased amounts may mean lung disease.
Dark yellow or green. This often means a bacterial infection, such as pneumonia. Yellowish-green sputum is also common in people with cystic fibrosis. Cystic fibrosis is an inherited disease that causes mucus to build up in the lungs and other organs.
Black. This often shows up in people who smoke. It is also a common sign of black lung disease. Black lung disease is a serious condition that can happen if you have long-term exposure to coal dust.
Brown or brown spots. This may be a sign of old blood. This can happen if you have cystic fibrosis, bacterial pneumonia, bacterial bronchitis, or some other lung diseases. It can also be caused by breathing in dust or other brown materials or toxins.
Pink. This may be a sign of pulmonary edema, a condition in which excess fluid builds up in the lungs. Pulmonary edema is common in people with heart failure.
Red. This may be an early sign of lung cancer. It may also be a sign of a pulmonary embolism (PE), a life-threatening condition in which a blood clot from a leg or other part of the body breaks loose and travels to the lungs. If you are coughing up red or bloody sputum, call 911 or seek immediate medical attention.
Find and diagnose bacteria or fungi that may be causing an infection in the lungs or airways
See if a chronic illness of the lungs has worsened
See if treatment for a lung or airway infection is working
Help to diagnose respiratory conditions such as pneumonia, tuberculosis, and bronchiectasis
A sputum culture is often done with another test called a Gram stain. A Gram stain is a test that checks for bacteria at the site of a suspected infection or in body fluids such as blood or urine. It can help identify the specific type of infection you may have.
A sputum test is not usually used if your provider thinks you may have a viral infection.
You may need this test if you have symptoms of pneumonia or another serious infection of the lungs or airways. These include:
Cough which produces a lot of sputum
Fever
Chills
Shortness of breath
Chest pain that gets worse when you breathe deeply or cough
Fatigue
Confusion, especially in older people
Your provider may also order a sputum culture after an x-ray or other imaging tests show that you may have a lung infection. The sputum culture can help confirm this and determine the cause of the infection.
Your provider will need to get a sample of your sputum. During the test:
You may be asked to rinse your mouth out with water before the sample is taken.
Your provider will ask you to breathe deeply and then cough deeply into a special cup.
A health care provider will ask you to breathe deeply and then cough deeply into a special cup.
Your provider may tap you on the chest to help loosen sputum from your lungs.
If you have trouble coughing up enough sputum, your provider may ask you to breathe in a salty mist to help you cough more deeply.
If you still can't cough up enough sputum, your provider may perform a procedure called a bronchoscopy. In this procedure, you'll first get a medicine to help you relax, and then a numbing medicine so you won't feel any pain.
Then a camera attached to a thin, lighted tube will be put through your mouth or nose and into your airway. This helps your provider see the inside of your lungs and airway.
Your provider will collect a sample from your airway using a small brush or suction.
The test is often scheduled in the morning. To increase the amount of sputum, you may be encouraged to drink more water the night prior. You may also be asked not to eat for one or two hours before the test.
If you will be getting a bronchoscopy, you may be asked to fast (not eat or drink) for up to twelve hours before the test.
You may need to stop taking certain medicines before this test, so tell your provider about everything you take. Antibiotics may affect bacterial growth and the results of your sputum culture test. But don't stop taking any medicines unless your provider tells you to.
There is no risk to providing a sputum sample into a container. If you had a bronchoscopy, your throat may feel sore after the procedure.
If you had a bronchoscopy:
Your throat may feel sore after the procedure
It may take a few hours to be able to cough normally.
You will not be permitted to eat or drink until you can cough normally again.
Your sputum sample will be put in a dish with a special substance that allows bacteria to grow. It usually takes a few days to get the results of your sputum culture, but it may take weeks. How long it takes to get your results will depend on the type of bacteria that you are being tested for, since some types of bacteria take longer to grow in the lab
If your results were normal, it means that no harmful bacteria or fungi were found.
If your results were not normal, it may mean you have some kind of bacterial or fungal infection. Your provider may need to do more tests to find the specific type of infection you have. The most common types of harmful bacteria found in a sputum culture include those that cause:
Pneumonia
Bronchitis
Tuberculosis
An abnormal sputum culture result may also mean a flare-up of a chronic condition, such as cystic fibrosis or chronic obstructive pulmonary disease (COPD). COPD is a lung disease that makes it hard to breathe.
If you have questions about your results, talk to your provider. To understand the results of your sputum culture, your provider will consider your symptoms, medical history, and the results of other tests.
Sputum may be referred to as phlegm or mucus. All terms are correct, but sputum and phlegm only refer to the mucus made in the respiratory tract (lungs and airways). Sputum (phlegm) is a type of mucus. Mucus can also be made elsewhere in the body, such as in the urinary or genital tract.
Sputum Cytology | LungCancer.net [accessed on Jan 01, 2019]
Sputum cytology in suspected cases of carcinoma of lung (Sputum cytology a poor man's bronchoscopy!) [accessed on Jan 01, 2019]
Sputum examination for early detection of lung cancer [accessed on Jan 01, 2019]
Sputum Cytology [accessed on Jan 01, 2019]
Lung Cancer Screening and Tests: LDCT, Biopsy, Bronchoscopy, and More [accessed on Jan 01, 2019]
Lung disease | womenshealth.gov [accessed on Jan 11, 2019]
009076: Sputum Cytology Series | LabCorp [accessed on Jan 11, 2019]
Sputum Culture and Cytology Study - MidMichigan Health [accessed on Jan 17, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Phlegm
Sputum
Image by Zhangmoon618
Mycobacterium tuberculosis
This illustration depicts a photomicrograph of a sputum specimen, processed using the Ziehl-Neelsen staining method, and revealed the presence of numerous, Mycobacterium tuberculosis bacteria. This bacterium can attack any part of the body, though usually the lungs, causing tuberculosis, and is spread through inhalation of infected sputum from a coughing, or sneezing individual.
Image by CDC
Sputum
Video by MSREducators/YouTube
How to Identify Haemophilus influenzae in a Sputum Culture
Video by Suzanne Clark/YouTube
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Image by Bobjgalindo
Phlegm
Zhangmoon618
Mycobacterium tuberculosis
CDC
4:18
Sputum
MSREducators/YouTube
8:03
How to Identify Haemophilus influenzae in a Sputum Culture
Suzanne Clark/YouTube
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Bobjgalindo
Lung Cancer Tumor Markers
Lung Cancer Genetic Tests
Also called: Lung Cancer Biomarker Testing, Lung Cancer Targeted Gene Panel, Lung Cancer Tumor Markers
Lung cancer genetic tests look for changes in the genes of the cancer cells in your body. The test results may guide treatment choices for targeted therapies.
Lung Cancer Genetic Tests
Also called: Lung Cancer Biomarker Testing, Lung Cancer Targeted Gene Panel, Lung Cancer Tumor Markers
Lung cancer genetic tests look for changes in the genes of the cancer cells in your body. The test results may guide treatment choices for targeted therapies.
If you have lung cancer, your health care provider may order genetic tests. These tests look for changes in the genes of the cancer cells in your body. Gene changes are also called gene variants or mutations. There are many types of gene changes that are found in lung cancer. Knowing what type of gene change you have may help your provider to:
Predict how your lung cancer will develop over time
Match your cancer to a targeted therapy that's most likely to help you
Targeted therapy uses drugs or other substances that mainly attack specific cancer cells and cause less harm to normal cells. It usually has fewer side effects than chemotherapy or radiation therapy.
There are different types of targeted therapies. Each type is designed to work for cancers with specific gene changes. So, lung cancer genetic tests are important to check if your cancer has a gene change that can be treated with targeted therapy.
There are two main types of lung cancer, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Most people with lung cancer have NSCLC. The most common lung cancer genetic tests are done for NSCLC. That's because this type of lung cancer is more likely to have gene changes that respond to targeted therapies.
Genes are parts of DNA in your cells that you inherit from your parents. Genes carry information that controls what you look like and how your body works. The gene changes found in lung cancer affect genes that control how fast your cells grow and divide to make new cells. Cells with these changes grow out of control and form cancerous tumors that can spread through your body.
The gene changes in lung cancer usually aren't inherited. That means you can't pass them down to your children. You develop gene changes in certain cells in your lungs after you're born. These changes can happen if you're exposed to substances that cause cancer, such as tobacco smoke, radon gas, or air pollution. Gene changes can also happen if your cells make a mistake when they divide to make new cells.
Lung cancer genetic testing is most often used to look for gene changes that are often involved in non-small cell lung cancer. The results may help guide treatment choices for targeted therapies.
There are many types of gene changes that can be involved in NSCLC. And researchers are still learning about more.
Lung cancer genetic tests may check a single gene or several genes may be checked in one test.
You may need a lung cancer genetic testing if you have been diagnosed with lung cancer. The test results may help your provider know which treatments are likely to help you the most and which ones may not help at all.
The best sample for lung cancer genetic tests is tissue from a tumor in your lung. The procedure to collect a tissue sample is called a biopsy. If you had a biopsy to diagnose your cancer, the same tissue may be used to test for gene changes.
There are several ways to do a lung biopsy. The type of biopsy you have depends on many things, including where the cancer is growing in your lungs. In certain cases, tissue may be removed with a special hollow needle inserted through your skin and into your lung.
A tissue sample may also be removed during a bronchoscopy or with a procedure that involves making an incision (cut) in your chest area to insert special tube-like instruments into your lung. Talk with your provider to find out which biopsy method will work for you.
If tumor tissue can't be collected, a blood test may be used for genetic testing in certain cases. Tumor cells shed DNA into your bloodstream. Testing the tumor DNA in your blood is called a "liquid biopsy." This test is not as accurate as tests that use tumor tissue. Researchers are still studying the use of liquid biopsies to test for certain gene changes.
Ask your provider if you need to do anything to prepare for your test.
If you have a biopsy, the risks depend on the type of procedure you have. In general, you may have a little bruising or bleeding at the biopsy site. You may also have some discomfort. Ask your provider about any risks involved with the test you're having.
If your lung cancer cells have a gene change that may respond well to a targeted therapy, your provider may start you on that treatment.
If your results show you don't have a gene change that matches a targeted therapy, your provider may discuss other treatment options. If you were tested for one gene change, other tests may be done to look for other gene changes that have targeted therapies.
Your test results may also show that your lung cancer has a gene change that:
May prevent a certain therapy from working. This information could spare you from getting treatment that won't help.
Doesn't help make treatment decisions. Researchers don't understand the importance of all the gene changes that are found in cancer.
Genetic testing may take longer than many other types of lab tests. So, you may not get your results for a few days to a week or more. If you have questions about your results, talk with your provider.
Lung Cancer Genetic Tests: MedlinePlus Medical Test [accessed on Dec 26, 2023]
ALK
ALK Genetic Test
Also called: ALK Gene Rearrangement
An ALK genetic test is most often used to guide treatment for certain cancers, especially non-small cell lung cancer. Some medicines are especially effective in cancer patients with ALK gene mutations.
ALK Genetic Test
Also called: ALK Gene Rearrangement
An ALK genetic test is most often used to guide treatment for certain cancers, especially non-small cell lung cancer. Some medicines are especially effective in cancer patients with ALK gene mutations.
{"label":"ALK gene rearrangement reference range","description":"This test detects the presence of <em>ALK<\/em> gene rearrangements in tumor tissue. It is used primarily to determine if a cancer or cancer-like condition is likely to respond to an ALK kinase inhibitor drug therapy.","scale":"lin","step":0.25,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"If your biopsy results showed that your type of cancer does not have an ALK gene rearrangement, then you are not likely to benefit from treatment with an ALK kinase inhibitor drug.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If your biopsy result came back positive, it means that your cancer tissue contains a specific ALK gene rearrangement mutation or altered ALK protein. Therefore, you are likely to benefit from treatment with an ALK kinase inhibitor drug such as crizotinib.","conditions":["Crizotinib (Xalkori)","Ceritinib (Zykadia)","Alectinib (Alecensa)","Brigatinib (Alunbrig)","Lorlatinib (Lorbrena)"]}],"hideunits":true,"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
If your biopsy results showed that your type of cancer does not have an ALK gene rearrangement, then you are not likely to benefit from treatment with an ALK kinase inhibitor drug.
Related conditions
The anaplastic lymphoma receptor tyrosine kinase (ALK) gene codes for a protein known as anaplastic lymphoma kinase, which is believed to participate in cell growth.
Mutations (changes) in the ALK gene and protein promotes the uncontrolled growth of cancer cells and have been found in various types of cancer, including lymphoma, neuroblastoma, and especially non-small cell lung cancer.
This test is used to identify specific mutations in the ALK gene in a sample of tumor tissue.
Your doctor might want to order an ALK genetic test if you were already diagnosed with non-small cell lung cancer (especially adenocarcinoma) because this test can help guide your doctor decide an appropriate therapeutic management plan that may include an ALK kinase inhibitor.
The ALK kinase inhibitor drugs, like for instance a medication called crizotinib, form part of what is called the “anti-cancer drugs.”
After using anesthesia, a biopsy procedure (taking a small piece of the affected tissue) is performed to collect a tumor sample, which then will be typically evaluated by a pathologist.
You may be asked to refrain from eating, but usually, no preparations are needed.
Biopsies are considered to be low-risk procedures, and they are usually completely pain-free. However, depending on the site from where the tissue sample is taken, you might feel bloated, uncomfortable, or have a sore throat.
As with most procedures, a biopsy also carries the risk of infection and bleeding.
If your biopsy result came back positive, it means that your cancer tissue contains a specific ALK gene rearrangement mutation or altered ALK protein. Therefore, you are likely to benefit from treatment with an ALK kinase inhibitor drug such as crizotinib, ceritinib, or alectinib.
If your biopsy results showed that your type of cancer does not have an ALK gene rearrangement, then you are not likely to benefit from treatment with an ALK kinase inhibitor drug.
This test is normally ordered along with or as a follow-up test to KRAS and epidermal growth factor receptor (EGFR) protein mutation testing.
In some cases, a negative ALK genetic test may be repeated if the tumor tissue sample was considered to be insufficient.
Definition of ALK gene - NCI Dictionary of Cancer Terms - National Cancer Institute [accessed on Sep 17, 2018]
ALK Mutation (Gene Rearrangement) [accessed on Sep 17, 2018]
ALK gene - Genetics Home Reference - NIH [accessed on Sep 17, 2018]
Guideline Recommendations for Testing of ALK Gene Rearrangement in Lung Cancer: A Proposal of the Korean Cardiopulmonary Pathology Study Group [accessed on Sep 17, 2018]
Lung Cancer Mutation Panel (EGFR, KRAS, ALK) [accessed on Sep 17, 2018]
Genetics of Non-Small Cell Lung Cancer: Practice Essentials, Targeting the Genetic Mutations, Genetic Testing [accessed on Sep 17, 2018]
https://www.oncotest.co.il/en/lung-cancer-en/lung-cancer-tests/alk-gene-rearrangement/ [accessed on Sep 17, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
BRAF
BRAF Genetic Test
Also called: BRAF Gene Mutation Analysis, BRAF Testing, BRAF Mutation Testing, BRAF V600 Mutation, BRAF Genetic Test
A BRAF genetic test looks for changes (mutations) in the BRAF gene. The BRAF gene belongs to a class of genes known as oncogenes. When mutated, oncogenes have the potential to cause normal cells to become cancerous. Test results can guide treatment for melanoma and certain other cancers.
BRAF Genetic Test
Also called: BRAF Gene Mutation Analysis, BRAF Testing, BRAF Mutation Testing, BRAF V600 Mutation, BRAF Genetic Test
A BRAF genetic test looks for changes (mutations) in the BRAF gene. The BRAF gene belongs to a class of genes known as oncogenes. When mutated, oncogenes have the potential to cause normal cells to become cancerous. Test results can guide treatment for melanoma and certain other cancers.
{"label":"BRAF genetic test reference range","description":"This test checks for certain changes (mutations) in the BRAF gene. A BRAF genetic test is most often used to guide treatment for certain cancers, most commonly melanoma. Results are reported as positive, negative or uncertain (VUS), and may include specific findings.","scale":"lin","step":0.25,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative (normal) result means that the test didn't find any harmful changes in your BRAF gene. If you have cancer, this result means your cancer is BRAF-negative and you will not benefit from BRAF-targeted therapy.","conditions":[]},{"flag":"borderline","label":{"short":"Uncertain","long":"Uncertain","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An uncertain (variant of unknown or uncertain significance) result means there isn\u2019t enough information about that genetic change to determine whether it is benign (normal) or pathogenic (disease causing). This type of result may be also called uninformative, indeterminate, inconclusive, or ambiguous.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":2,"max":3},"text":"A positive (abnormal) result means that the test identified harmful changes in your BRAF gene. If you have cancer, this result means your cancer is BRAF-positive and you may benefit from BRAF-targeted therapy.","conditions":[]}],"hideunits":true,"value":0.5}[{"negative":0},{"borderline":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative (normal) result means that the test didn't find any harmful changes in your BRAF gene. If you have cancer, this result means your cancer is BRAF-negative and you will not benefit from BRAF-targeted therapy.
Related conditions
A BRAF genetic test uses a sample of tumor tissue, bone marrow, or blood to look for changes in a gene called BRAF. Changes in your genes are also called gene variants or mutations. The test is usually done to look for changes in the BRAF gene that may be involved in cancer.
Genes are parts of DNA in your cells that you inherit from your parents. Genes carry information that controls what you look like and how your body works. The BRAF gene provides instructions for making a protein that tells your cells when to grow and divide to make new cells.
Certain changes in your BRAF gene may change the gene's instructions and lead to BRAF proteins that are too active. These abnormal BRAF proteins trigger too much cell growth. As a result, cells that have the changed BRAF gene may grow out of control and become cancer.
Changed BRAF genes and their proteins are commonly found in melanoma, the most serious form of skin cancer. Changes are also found in several other types of cancer, including colon, thyroid, ovarian, lung, and certain blood cancers.
Cancers with changes in the BRAF gene tend to grow more quickly than cancers that don't have this gene change. Knowing whether your cancer has a changed BRAF gene can help your health care provider choose the most effective treatment for you.
Changes in your BRAF genes can be acquired or inherited from your parents:
Acquired changes in your BRAF genes develop sometime after you're born. Most changes in BRAF genes are acquired. These changes can happen if your cells make a mistake when they divide to make new cells. Changes can also happen if you're exposed to substances that cause cancer. Acquired changes in genes show up only in certain types of cells. They're usually not in sperm or egg cells, so you can't pass them down to children.
Inherited changes in your genes are changes that you're born with. All the cells in your body have the gene change, including your egg or sperm cells. That means you can pass the change down to your children. Inherited changes in the BRAF gene are very rare, but they can increase your risk of cancer or cause different types of genetic conditions that are present from birth.
BRAF genetic testing may be used to:
Look for changes in the BRAF gene in certain types of cancer. This information may be used to diagnose certain types of cancer and/or guide treatment decisions.
Check for inherited changes in the BRAF gene. This is not a routine screening test. But it may be used if your personal or family health history suggests that you may have a high risk for cancer or another condition that's caused by inherited changes in the BRAF gene. Your risk of cancer from inherited gene change may be high if:
You or a family member have had cancer at an unusually young age
You have several close family members who have the same type of cancer
You or a family member have two or more types of cancer
You may need a BRAF genetic test if you:
Have a cancer that could be caused by changes in your BRAF gene. The results from a BRAF genetic test can help your provider:
Predict how fast your cancer may grow.
Know whether targeted treatment is likely to help you. Targeted treatment for cancer with changes in BRAF genes blocks or slows the abnormal proteins that make cancer grow. These medicines could be harmful if they are prescribed for cancers that don't have changed BRAF genes. So BRAF testing is needed to match you with the best treatment for your cancer.
Understand how your cancer may respond to treatments, such as chemotherapy or radiation therapy.
Have a personal or family health history that increases your risk of cancer involving inherited changes in your BRAF gene. A BRAF genetic test can help you estimate and manage your cancer risk. The test can also show whether you could pass a changed BRAF gene to your children.
Have a family health history of a genetic condition caused by BRAF gene changes. BRAF genetic testing can help you understand if you and your partner have BRAF gene changes that you could pass to your children.
If you're considering a BRAF gene test to look for an inherited gene change, a genetic counselor can help you consider the pros and cons of this test.
If you're having a BRAF genetic test because you have cancer, the test will depend what type of cancer you have:
For solid tumors, the test often uses a sample of cells from the tumor. The sample may be taken:
During surgery to remove the entire tumor.
With a biopsy to remove a small amount of tissue. The type of biopsy you have depends on where your cancer is located. A biopsy may be done with:
A hollow needle inserted through your skin. Imaging tests, such as ultrasound may be used to guide the needle.
Minor surgery to remove a sample of tissue (an incisional biopsy).
With a blood test. If surgery or a biopsy isn't possible, you may have a blood test to look for DNA that the tumor has shed in your bloodstream. This is called a "liquid biopsy." To do a blood test, a health care professional will use a small needle to take a blood sample from a vein in your arm.
For blood cancer, a blood test or a bone marrow test may be used. Marrow is soft, spongy tissue found inside of bones. Most bone marrow samples are taken from the back of the hip bone.
If you're having a BRAF genetic test to check for inherited gene changes, you will usually have a blood test.
If you're having a blood test, you usually don't need any special preparations. Ask your provider about how to prepare for other types of BRAF gene tests.
The risks of a BRAF gene test depend on how your sample is collected. Talk with your provider about your risks.
In general, with a biopsy, you may have soreness, pain, or bleeding where the tissue was removed.
A blood test has very little risk. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
After a bone marrow test, you may feel stiff or sore where the sample was taken. This usually goes away in a few days. Serious symptoms are very rare, but may include swelling, bleeding at the site, or fever.
If you have cancer and your test results show:
You have a change in your BRAF gene, your provider may prescribe medicines that are designed to target the changed BRAF proteins that are making your cancer grow. You may also need other treatments.
You don't have a change in your BRAF gene, your provider will prescribe another type of treatment for your cancer.
If you don't have cancer and your results show you have a change in your BRAF gene, it does not mean you'll get cancer. But, depending on the change, you may have a higher risk of developing cancer.
You may be able to reduce your risk by having more frequent cancer screenings. For example, to reduce or risk of melanoma, you can have more skin exams to check your whole body for moles and other suspicious growths. Cancer screening can help catch cancer early when it's easier to treat.
If you have an inherited change in your BRAF gene, talk with your provider or a genetic counselor to learn about the risks of passing the change to your children.
BRAF Genetic Test: MedlinePlus Lab Test Information [accessed on Dec 23, 2023]
BRAF gene - Genetics Home Reference - NIH [accessed on Oct 03, 2018]
BRAF - My Cancer Genome [accessed on Oct 03, 2018]
481030: BRAF Gene Mutation Analysis | LabCorp [accessed on Oct 03, 2018]
An EGFR genetic test is most often used to guide treatment for certain cancers. It helps determine whether treatment with EGFR-targeted drugs would be beneficial for you.
An EGFR genetic test is most often used to guide treatment for certain cancers. It helps determine whether treatment with EGFR-targeted drugs would be beneficial for you.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
If your biopsy results showed that your type of cancer does not have an EGFR gene mutation, then you are not likely to benefit from treatment with a tyrosine kinase inhibitor drug.
Related conditions
{"label":"EGFR exon 20 insertion reference range","description":"This test detects EGFR exon 20 insertion mutations. An EGFR exon 20 insertion mutation is a biomarker of certain mutated cancer cells. Some common treatments, such as some tyrosine kinase inhibitors (TKIs), may not work for these mutations.","scale":"lin","step":0.25,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A positive EGFR test, negative for exon 20 means you are likely to benefit from treatment with tyrosine kinase inhibitors, like gefitinib or erlotinib.","conditions":["Afatinib","Dacomitinib","Erlotinib","Gefitinib","Osimertinib","Ramucirumab with Erlotinib"]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If you are diagnosed with the EGFR exon 20 mutation, you may be recommended chemotherapy, and immunotherapy. Exon 20 mutations are resistant to typical EGFR tyrosine kinase inhibitors (TKIs).","conditions":["Amivantamab-vmjw","Carboplatin","Cisplatin","Pemetrexed"]}],"hideunits":true,"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
A positive EGFR test, negative for exon 20 means you are likely to benefit from treatment with tyrosine kinase inhibitors, like gefitinib or erlotinib.
Related conditions
Afatinib
Dacomitinib
Erlotinib
Gefitinib
Osimertinib
Ramucirumab with Erlotinib
EGFR is a protein found on certain types of cells that binds to a substance called epidermal growth factor. The EGFR protein is involved in cell signaling pathways that control cell division and survival. Sometimes, mutations (changes) in the EGFR gene cause EGFR proteins to be made in higher than normal amounts on some types of cancer cells. This causes cancer cells to divide more rapidly.
Drugs that block EGFR proteins are being used in the treatment of some types of cancer, including colon cancer, brain cancer, pancreas cancer, and especially in non-small cell lung cancer. EGFRs are a type of receptor tyrosine kinase.
An EGFR genetic test identifies specific rearrangements in the EGFR gene present in a tumor tissue sample (biopsy).
Your doctor might want to order an EGFR test if you were already diagnosed with non-small cell lung cancer.
This test can help your doctor decide on an appropriate therapeutic management plan that may include tyrosine kinase inhibitors, like for instance drugs such as gefitinib and erlotinib.
Tyrosine kinase inhibitors (TKIs) block the action of EGFR, which cause cell growth inhibition, making it effective for cancer treatment.
After using anesthesia, a biopsy procedure (taking a small piece of the affected tissue) is performed to collect a tumor sample, which then will be evaluated by a pathologist.
You may be asked to refrain from eating, but, usually, no preparations are needed. Follow the instructions provided by your health-care practitioner.
Biopsies are considered to be low-risk procedures, and they are usually entirely pain-free. However, depending on the site from where the tissue sample is taken, you might feel bloated, uncomfortable, or have a sore throat.
As with most procedures, a biopsy also carries the risk of infection and bleeding.
If your biopsy result came back positive, it means that your cancer tissue contains a specific EGFR gene mutation. Therefore, you are likely to benefit from treatment with tyrosine kinase inhibitors, like gefitinib or erlotinib.
If your biopsy results showed that your type of cancer does not have an EGFR gene mutation, then you are not likely to benefit from treatment with a tyrosine kinase inhibitor drug.
This test is normally ordered along with or as a follow-up test to KRAS and anaplastic lymphoma receptor tyrosine kinase (ALK) mutation testing.
In some cases, a negative EGFR test may be repeated if the tumor tissue sample was considered to be insufficient.
EGFR Mutation Testing [accessed on Oct 03, 2018]
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/egfr [accessed on Oct 03, 2018]
EGFRD - Clinical: Cell-Free DNA EGFR Exon 18, 19, 20, 21, Mutation Analysis, Blood [accessed on Oct 03, 2018]
EGFRT - Clinical: EGFR Gene, Mutation Analysis, 29 Mutation Panel, Tumor [accessed on Oct 03, 2018]
489360: Epidermal Growth Factor Receptor (EGFR) Gene... | LabCorp [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
What are the different types of EGFR Mutations?
Video by American Lung Association/YouTube
Advice for EGFR Patients: Ashley
Video by American Lung Association/YouTube
Treatment Options for EGFR-positive Lung Cancer
Video by American Lung Association/YouTube
The Future of Treatment For EGFR-positive Lung Cancer
Video by American Lung Association/YouTube
Lung Cancer Biomarker Testing: A Caregiver’s Perspective
Video by American Lung Association/YouTube
Introduction to EGFR inhibitors
Video by LUNGevityFoundation/YouTube
VEGF and EGFR pathways in detail: Target for new therapies against cancer
Video by Bowel Cancer Australia/YouTube
Ask the Expert: Personalized Care - What You Need to Know (Highlights)
Video by American Lung Association/YouTube
2:16
What are the different types of EGFR Mutations?
American Lung Association/YouTube
1:16
Advice for EGFR Patients: Ashley
American Lung Association/YouTube
1:59
Treatment Options for EGFR-positive Lung Cancer
American Lung Association/YouTube
1:21
The Future of Treatment For EGFR-positive Lung Cancer
American Lung Association/YouTube
0:31
Lung Cancer Biomarker Testing: A Caregiver’s Perspective
American Lung Association/YouTube
5:32
Introduction to EGFR inhibitors
LUNGevityFoundation/YouTube
4:22
VEGF and EGFR pathways in detail: Target for new therapies against cancer
Bowel Cancer Australia/YouTube
3:56
Ask the Expert: Personalized Care - What You Need to Know (Highlights)
American Lung Association/YouTube
KRAS
KRAS Genetic Test
Also called: KRAS gene mutations, KRAS mutation analysis, KRAS sequence analysis, KRAS Genetic Test
A KRAS genetic test is most often used to guide treatment for certain cancers, particularly colon and non-small cell lung cancer. Some medicines are especially effective in cancer patients with KRAS mutations.
KRAS Genetic Test
Also called: KRAS gene mutations, KRAS mutation analysis, KRAS sequence analysis, KRAS Genetic Test
A KRAS genetic test is most often used to guide treatment for certain cancers, particularly colon and non-small cell lung cancer. Some medicines are especially effective in cancer patients with KRAS mutations.
{"label":"KRAS genetic test reference range","description":"This test detects specific mutations in the <em>KRAS<\/em> gene in the DNA of cancer cells and tissue. The result is reported as negative (wild-type) or positive (mutant) and may indicate the specific mutation \u2014 eg \"KRAS G12C\" or \"KRAS G12V\". The test is used to predict which treatments may be more or less effective against a particular cancer.","scale":"lin","step":0.25,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative or wild-type (WT) result means there is no <em>KRAS<\/em> mutation in your cancer. <em>KRAS<\/em> wild-type cancers are sensitive to EGFR inhibitors.","conditions":["Afatinib","Cetuximab","Erlotinib","Gefitinib","Lapatinib","Osimertinib","Panitumumab","Vandetanib"]},{"flag":"borderline","label":{"short":"Uncertain","long":"Uncertain","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":2,"max":3},"text":"A positive or mutant result means that there is a <em>KRAS<\/em> mutation in your cancer. Mutations in the <em>KRAS<\/em> gene cause roughly one-third of all cancers. A common <em>KRAS<\/em> mutation, called G12C, is found in about 13% of people with non-small cell lung cancer, 3% of people with colorectal cancer, and 1% to 3% of people with other solid tumors. Some cancers may benefit from KRAS-targeted drugs.","conditions":["Adagrasib (Krazati)","Sotorasib (Lumakras)"]}],"hideunits":true,"value":0.5}[{"negative":0},{"borderline":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
KRAS mutation in your cancer. KRAS wild-type cancers are sensitive to EGFR inhibitors.
Related conditions
Afatinib
Cetuximab
Erlotinib
Gefitinib
Lapatinib
Osimertinib
Panitumumab
Vandetanib
KRAS gene provides instructions for making a protein called K-Ras. These proteins play important roles in cell division, cell differentiation, and the self-destruction of cells (apoptosis). KRAS gene belongs to a class of genes known as oncogenes. When there is a gene mutation, oncogenes can turn normal cells into cancerous cells.
KRAS genetic test is used to detect the most common KRAS mutations in the DNA cells and help to guide cancer treatment.
It is ordered to evaluate the response to a therapy with anti-epidermal growth factor receptor (anti-EGFR) drug therapy in patients with colon cancer and non-small cell lung cancer.
A doctor may perform this test after an individual has been diagnosed with colon cancer or non-small cell lung cancer, to test for drug sensitivity with epidermal growth factor receptor-targeted therapies.
After using anesthesia, a biopsy procedure (taking a small piece of the affected tissue) is performed to collect a tumor sample, which then will be evaluated by a pathologist.
You may be asked to refrain from eating, but usually, no preparations are needed. Follow the instructions provided by your health-care practitioner.
Risks of a biopsy depend on size, place of biopsy and type of procedure, among several other variables. There is a risk of infection, bleeding and accidental injury to a nearby tissue/organ where the biopsy was taken. There is also a risk of spreading the cancer cells.
If the biopsy result of the cancer tissue evaluated is:
Positive for KRAS mutation: this person is not eligible for treatment with anti-EGFR drug therapy.
Negative for KRAS mutation: this person may respond to anti-EGFR therapy.
However, there can be false negatives.
According to the American Society of Clinical Oncology, their guidelines suggest doing KRAS genetic test to evaluate drug therapy response, before treatment with epidermal growth factor receptor-targeted therapies.
KRAS Mutation [accessed on Oct 03, 2018]
Medscape: Medscape Access [accessed on Oct 03, 2018]
KRASC - Clinical: KRAS Mutation Analysis, 7 Mutation Panel, Colorectal [accessed on Oct 03, 2018]
KRASO - Clinical: KRAS Mutation Analysis, 7 Mutation Panel, Other (Non-Colorectal) [accessed on Oct 03, 2018]
481075: KRAS Gene Mutation Analysis, Extended | LabCorp [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (4)
Learning More about KRAS Lung Cancer
Video by American Lung Association/YouTube
Advice for KRAS Patients: Nancy
Video by American Lung Association/YouTube
Advice for KRAS Patients: Jennifer
Video by American Lung Association/YouTube
Treating KRAS G12C Mutations
Video by American Lung Association/YouTube
2:17
Learning More about KRAS Lung Cancer
American Lung Association/YouTube
1:27
Advice for KRAS Patients: Nancy
American Lung Association/YouTube
0:58
Advice for KRAS Patients: Jennifer
American Lung Association/YouTube
1:42
Treating KRAS G12C Mutations
American Lung Association/YouTube
PD-L1
PD-L1 (Immunotherapy) Tests
Also called: Programmed Death-Ligand 1, PDL1, PD-LI, PDL1 Testing, PD-L1
A PD-L1 test measures a protein on cancer cells that stops your immune system from attacking cancer. The test can guide immunotherapy choices. There are many types of PD-L1 tests.
PD-L1 (Immunotherapy) Tests
Also called: Programmed Death-Ligand 1, PDL1, PD-LI, PDL1 Testing, PD-L1
A PD-L1 test measures a protein on cancer cells that stops your immune system from attacking cancer. The test can guide immunotherapy choices. There are many types of PD-L1 tests.
{"label":"PD-L1 reference range","description":"This test measures what percentage of cells in a tumor \"express\" PD-L1. PD\u2060-\u2060L1 protein that acts as a kind of \"brake\" to keep the body\u2019s immune responses under control. PD\u2060-\u2060L1 expression level is reported as a percentage on a scale of 0% to 100%.","scale":"lin","step":1,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative or \"not detected\" result means your tumor cells don't have enough PD-L1, and that immunotherapy is not likely to help you. Your provider will consider another type of cancer treatment.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":50},"text":"A positive or \"detected\" result means your tumor cells have enough PD-L1 for you to use immunotherapy medicine, you may be able to start that medicine.","conditions":["Atezolizumab (Tecentriq)","Durvalumab (Imfinzi)","Nivolumab (Opdivo)","Pembrolizumab (Keytruda)"]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":50,"max":100},"text":"Tumors that express high amounts of PD-L1 (50% or greater) may respond particularly well to checkpoint inhibitors (a type of immunotherapy drug).","conditions":["Atezolizumab (Tecentriq)","Durvalumab (Imfinzi)","Nivolumab (Opdivo)","Pembrolizumab (Keytruda)"]}],"units":[{"printSymbol":"%","code":"%","name":"percent"}],"hideunits":false,"value":0}[{"negative":0},{"positive":0},{"positive":1}]
Use the slider below to see how your results affect your
health.
%
1
50
Your result is Negative.
A negative or "not detected" result means your tumor cells don't have enough PD-L1, and that immunotherapy is not likely to help you. Your provider will consider another type of cancer treatment.
Related conditions
A PD-L1 test uses a sample of cancerous tumor tissue to measure how much of a protein called PD-L1 is found on the cancer cells. If you have certain types of cancer, PD-L1 testing can check whether you may benefit from a type of cancer treatment called immunotherapy. Immunotherapy helps your own immune system fight cancer.
Normally, PD-L1 is found on certain healthy cells. It acts as a kind of "brake" to stop cells in your immune system, called T cells, from attacking healthy cells in your body. If cancer cells have high amounts of PD-L1, they can turn your T cells off so they can't attack the cancer cells.
If high amounts of PD-L1 are found on cancer cells, immunotherapy medicines called "immune checkpoint inhibitors" may be used. These medicines prevent the PD-L1 protein from putting the brakes on T cells. This frees your T cells to fight cancer.
Immunotherapy can help stop or slow the growth of many types of cancers that have PD-L1. Immunotherapy has fewer side effects than cancer chemotherapy. But it can cause serious side effects in some people, and not everyone benefits from it.
There are many types of PD-L1 tests. The test your health care provider orders will depend on:
The type of cancer you have
The specific immunotherapy medicine that your provider is considering for you
PD-L1 testing is used to look for the PD-L1 protein on cancer cells in a sample of tumor tissue. The test also measures the amount of PD-L1 in the tissue. This information helps find out if immunotherapy medicines could help control your cancer.
If you've been diagnosed with cancer, you may need PD-L1 testing to find out if immunotherapy could help you. Many types of cancer have immunotherapy treatments related to PD-L1. These cancers include:
Non-small cell lung cancer
Melanoma
Hodgkin lymphoma
Bladder cancer
Kidney cancer
Breast cancer
Head and neck cancer (squamous cell carcinoma)
Cancer of the esophagus (squamous cell carcinoma)
Stomach cancer (adenocarcinoma)
Cervical cancer
PD-L1 tests are done on a tissue sample from a tumor. If you're having surgery to remove a tumor, a sample will be taken for testing.
If you aren't having the tumor removed, you may have a biopsy, which is a procedure to remove a small amount of tissue for testing. If you already had a biopsy to diagnose your cancer, the same tissue sample may be used to test for PD-L1.
There are many ways to do a biopsy. The type of biopsy you have depends on the type of cancer you have and where the tumor is located. In general, a biopsy may be done using:
A hollow needle inserted through your skin. Imaging tests, such as ultrasound, may be used to guide the needle:
A fine needle aspiration biopsy uses a very thin needle to remove a sample of cells and/or fluid.
A core needle biopsy uses a larger needle to remove a sample.
Surgery. Surgery may be done to remove a sample of tissue (an incisional biopsy). In certain cases, the entire tumor will be removed (an excisional biopsy).
A scope. Scopes are tools for looking inside your body. They may be inserted through an opening in your body or through a small incision (cut). Special tools may be used with a scope to remove a tissue sample. Examples of scope procedures include bronchoscopy, laparoscopy, colposcopy, and cystoscopy (to examine the inside of the bladder).
Preparations for your test depend on how your tissue sample will be taken. Ask your provider how to prepare for your test.
Risks depend on how your tissue sample is taken. In general, if you are having a biopsy, you may have a little bruising or bleeding where the tissue was removed. Ask your provider to explain any risks from the test you're having.
Your test results will show whether you have enough PD-L1 protein in your tumor for you to benefit from a specific immunotherapy medicine. Some immunotherapy medicines will not be helpful if a small percentage of your cancer cells have PD-L1.
If your test results show that:
Your tumor cells have enough PD-L1 for you to use immunotherapy medicine, you may be able to start that medicine. This may be called a "positive" test result.
Your tumor cells don't have enough PD-L1, then the immunotherapy is not likely to help you. This may be called a "negative" test result. Your provider will consider another type of cancer treatment.
Your provider may also use other tests to help decide on the best treatment for you. If you have questions about your results, talk with your provider.
Immunotherapy is a quickly changing area of medicine. For some immunotherapy medicines, PD-L1 testing is required to see if you are a good match for that treatment. For other medicines, testing is only recommended. But new research may change how tests are used to choose treatments. So, check with your provider to find out how PD-L1 testing may affect your treatment plan.
PDL1 (Immunotherapy) Tests: MedlinePlus Medical Test [accessed on Dec 20, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Cancer Immunotherapy - PD-1 and PD-L1
Video by ImmunoOncology/YouTube
Detecting Abnormal Cells in the Cervix - CD3 (yellow); CD8 (red); PD1 (pink) and PDL1 (green).
This image of cellular infiltrate in mucous membrane cells of the cervix visualizes a panel of biomarkers indicating abnormal expansion or a growth. The biomarkers detected include CD3 (yellow); CD8 (red); PD1 (pink) and PDL1 (green). The blue color represents the cell nucleus. The intensity of each fluorescent signal can be measured and interpreted as the amount of that particular protein present in the tissue sample. This image indicates the presence of different inflammatory cells and immune regulatory cells present in the cellular infiltrate.
Image by National Cancer Institute \ Tisch Cancer Institute at the Mount Sinai School of Medicine / Tin Htwe Thin
Cancer therapy by inhibition of negative immune regulation (CTLA4, PD1)
Image by Brennick CA, George MM, Corwin WL, Srivastava PK, Ebrahimi-Nik H/Wikimedia
PD-L1 positive lung adenocarcinoma -- high mag
Micrograph showing a PD-L1 positive lung adenocarcinoma. PD-L1 immunostain.
Image by https://commons.wikimedia.org/wiki/File:PD-L1_positive_lung_adenocarcinoma_--_high_mag.jpg
B7 family ligands and CD28 family receptors
This diagram shows binding of costimulatory molecules on APCs and T cells. It shows B7 family ligands and their interactions with CD28 family receptors.
Image by The Immunologist/Wikimedia
Cancer immunotherapy | The PD-L1 pathway
Video by Roche/YouTube
PD-L1 – Immunotherapy: Unleashing the body to fight cancer | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
What is PD-1? Ask a Scientist
Video by Cancer Research Institute/YouTube
How Does Anti-PD-1 Therapy Help Fight Cancer?
Video by Johns Hopkins Medicine/YouTube
PD-L1 Testing and Developmental Process for Companion Diagnostic Tests
Video by RocheDiagnosticsUSA/YouTube
PD-L1 Biomarker Testing
Video by OncLiveTV/YouTube
Tumour immunology and immunotherapy
Video by nature video/YouTube
Immunotherapy: Moving beyond PD1 and PDL1 inhibitors
Video by ImedexCME/YouTube
4:00
Cancer Immunotherapy - PD-1 and PD-L1
ImmunoOncology/YouTube
Detecting Abnormal Cells in the Cervix - CD3 (yellow); CD8 (red); PD1 (pink) and PDL1 (green).
National Cancer Institute \ Tisch Cancer Institute at the Mount Sinai School of Medicine / Tin Htwe Thin
Cancer therapy by inhibition of negative immune regulation (CTLA4, PD1)
Guido4
Neoepitope
Brennick CA, George MM, Corwin WL, Srivastava PK, Ebrahimi-Nik H/Wikimedia
PD-L1 – Immunotherapy: Unleashing the body to fight cancer | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
2:01
What is PD-1? Ask a Scientist
Cancer Research Institute/YouTube
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How Does Anti-PD-1 Therapy Help Fight Cancer?
Johns Hopkins Medicine/YouTube
12:39
PD-L1 Testing and Developmental Process for Companion Diagnostic Tests
RocheDiagnosticsUSA/YouTube
4:47
PD-L1 Biomarker Testing
OncLiveTV/YouTube
5:04
Tumour immunology and immunotherapy
nature video/YouTube
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Immunotherapy: Moving beyond PD1 and PDL1 inhibitors
ImedexCME/YouTube
Bronchoscopy
Bronchoscopy and Bronchoalveolar Lavage
Also called: Bronchoscopy, Flexible Bronchoscopy, Bronchoalveolar Lavage, Bronchoalveolar Washing
Bronchoscopy is a procedure that uses a thin tube called a bronchoscope to look at the lungs. Bronchoalveolar lavage is a test that is sometimes done during a bronchoscopy. It is used to collect a fluid sample for testing.
Bronchoscopy and Bronchoalveolar Lavage
Also called: Bronchoscopy, Flexible Bronchoscopy, Bronchoalveolar Lavage, Bronchoalveolar Washing
Bronchoscopy is a procedure that uses a thin tube called a bronchoscope to look at the lungs. Bronchoalveolar lavage is a test that is sometimes done during a bronchoscopy. It is used to collect a fluid sample for testing.
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Use the slider below to see how your results affect your
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Your result is Normal.
A normal result means that the large airway leading to the lungs and the breathing tubes in the lungs appear normal. No foreign substances or blockages are seen.
Related conditions
{"label":"Bronchial biopsy reference range","description":"Bronchial biopsy is a procedure in which a bronchoscope is used to take very small tissue samples from the lungs. The bronchoscope is inserted through the nose or mouth into the lungs. Tiny brushes, needles, or forceps may be passed through the bronchoscope to remove lung tissue. This is done during a bronchoscopy.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal or negative result means that the biopsied tissue is normal.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A normal or positive result means that cancerous cells were found in the biopsied tissue.","conditions":["Lung cancer"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
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A normal or negative result means that the biopsied tissue is normal.
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A bronchoscopy is a procedure that's used to check for the cause of a lung problem. It can also be used to treat some lung diseases.
The procedure uses a bronchoscope, which is a thin, lighted tube with a tiny camera. This allows your health care provider to view images of your airways. The tube is put through your mouth or nose, down your throat, and into your airways. The tube is usually flexible but can also be rigid:
A flexible bronchoscope may be used to keep your airway open, suck up secretions (mucus made in your airways), or take a tissue sample (biopsy).
A rigid bronchoscope may be used to treat a tumor or bleeding or to remove something large stuck in your airway. It may also be used to insert a stent, which is a tiny tube placed in your airway to help you breathe.
Bronchoalveolar lavage (BAL) is a procedure that is sometimes done during a bronchoscopy. It's done to collect a sample from your lungs. It is also called bronchoalveolar washing. During the procedure, a saline solution is put through the bronchoscope to wash your airways and capture a fluid sample. The cells or bacteria in the fluid sample may be tested for infections or certain lung conditions.
Other names: flexible bronchoscopy, bronchoalveolar washing
Bronchoscopy may be used to:
Find and treat growths or other blockages in your airways
Remove lung tumors
Control bleeding in your airway
Help find the cause of certain lung symptoms such as a cough that doesn't go away
Help guide placement of a breathing tube
Place medicine in your lungs to treat certain conditions
Help determine how severe lung cancer is (if you have already been diagnosed with it)
Bronchoscopy with BAL is used to collect tissue for testing, to help diagnose certain lung diseases such as:
Bacterial infections such as tuberculosis and bacterial pneumonia
Fungal infections
Lung cancer
You may need one or both tests if you have symptoms of a lung disease, such as:
A cough that doesn’t go away
Trouble breathing
Coughing up blood
You may also have one or both tests if a chest x-ray or another imaging test shows a potential problem with your lungs.
If you have an immune system disorder, you may be more likely to get certain lung problems. For example, HIV or an organ transplant can put you at higher risk for some lung infections. If your provider thinks that you may have a lung infection or other lung problem, they can use bronchoscopy, often with a BAL, to make a diagnosis. Getting an early diagnosis helps you get the correct treatment as soon as possible.
Bronchoscopy and BAL are often done by a pulmonologist. A pulmonologist is a doctor who specializes in diagnosing and treating lung diseases.
A bronchoscopy takes about 30 to 90 minutes and usually includes the following steps:
You may need to remove some or all of your clothing. If so, you will be given a hospital gown.
You may also need to remove dentures and any removable dental appliances.
You will lie on a bed or table with your head raised.
You may get medicine (sedative) to help you relax. The medicine will be injected into a vein or given through an IV (intravenous) line placed in your arm or hand.
Your provider will spray a numbing medicine in your mouth and throat so you won’t feel any pain during the procedure.
Your provider will insert the bronchoscope down your throat and into your airways. The camera on the bronchoscope will take photos and connect to a video screen.
As the bronchoscope is moved down, your provider can look into your airways and lungs through the bronchoscope and on the video screen.
Your provider may perform other treatments at this time, such as removing a tumor or clearing a blockage.
At this point, you may also get a BAL.
During a BAL:
Your provider will put a small amount of saline through the bronchoscope.
After washing the airways, the saline is sucked up into the bronchoscope.
The saline solution will contain cells and other substances, such as bacteria, which will be taken to a lab for testing.
You may need to fast (not eat or drink) for several hours before your procedure. Your provider will let you know how long you need to avoid food and drink.
You may need to stop taking certain medicines before this test, so tell your provider about everything you take. But don’t stop taking any medicines unless your provider tells you to.
Your mouth and throat may be numb for a few hours.
You will have to wait to eat or drink until the numbness is gone.
If you’ve been given a sedative, you may be drowsy for a few hours after your procedure and should arrange to have someone take you home.
You may have a sore throat, cough, or hoarseness for a day or more.
There is very little risk to having a bronchoscopy or a BAL. Serious complications are rare, but they may include bleeding in the airways, infection, or a pneumothorax (collapse of part of your lung).
If your bronchoscopy results were not normal, it may be a sign of lung disorder such as:
A blockage, growth, or tumor in the airways
Narrowing of part of the airways
Lung damage due to an immune disorder such as rheumatoid arthritis
If you had BAL and your lung sample results were not normal, it may be a sign of lung cancer or a type of infection such as:
Tuberculosis
Bacterial pneumonia
Fungal infection
If you have questions about your results, talk to your provider. Your provider may consider your symptoms, medical history, and the results of other tests to understand the results of your procedure.
In addition to BAL, other procedures can be done during a bronchoscopy. These include:
Sputum culture. Sputum is a thick type of mucus made in your lungs. It is different than spit or saliva. A sputum culture checks for certain types of infections.
Laser therapy or radiation to treat tumors or cancer
Treatment to control bleeding in the lungs
If you had a tissue sample taken, you may also have a chest x-ray done to check for any issues.
Bronchoscopy and Bronchoalveolar Lavage (BAL): MedlinePlus Medical Test [accessed on Aug 29, 2024]
https://www.nhlbi.nih.gov/health-topics/bronchoscopy [accessed on Mar 22, 2019]
https://medlineplus.gov/ency/article/003857.htm [accessed on Mar 22, 2019]
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/pulmonary/bronchoscopy_92,p07743 [accessed on Mar 22, 2019]
https://www.bupa.co.uk/health-information/lungs-breathing/bronchoscopy [accessed on Mar 22, 2019]
https://www.cdc.gov/tb/education/corecurr/pdf/chapter4.pdf#page12 [accessed on Sep 17, 2019]
Additional Materials (20)
Bronchoscopy
Video by Tan Tock Seng Hospital/YouTube
Bronchoscopy - examination of your airways (English version)
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Intro to Bronchoscopy: Risks, indications, contraindications and obtaining consent -- BAVLS
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Sensitive content
This media may include sensitive content
Bronchoscopy
Seen is a Caucasian male physician using a bronchoscope which is a flexible tube with a light inside and is inserted into the patient's trachea. Doctors can view inside the body through the tube allowing easier access to removal of tumors.
Image by National Cancer Institute / Unknown Photographer
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This media may include sensitive content
What To Expect Before, During and After a Bronchoscopy
Diagram showing a bronchoscopy.
Image by Cancer Research UK / Wikimedia Commons
Rigid bronchoscopy
Rigid bronchoscopy
Image by JBARRETO
Small Cell Lung Cancer
There is extensive growth of small cell lung carcinoma on the pleural surface of one lung simulating the appearance of mesothelioma.
Image by Yale Rosen from USA
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This media may include sensitive content
What Does Bronchoscopy Show?
Lung cancer in the left. bronchus as seen with a bronchoscope.
Image by JHeuser
Diagnostic Bronchoscopy
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EBUS guide for patients: bronchoscopy technique for chest abnormalities
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Electromagnetic Navigation Bronchoscopy
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Robotic bronchoscopy - Mayo Clinic
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Bronchoscopy Procedure, South West Acute Hospital
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Using a Bronchial Scope for a Bronchoscopy at Christian Hospital in St. Louis, Missouri
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Bronchoscopy & Lung Nodule Biopsy | Fox Chase Cancer Center
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All About Bronchoscopy
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Bronchoscopic Foreign Body Removal -- BAVLS
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Sedation for Bronchoscopy (English version)
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What happens during a bronchoscopy?
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Bronchoscopy Patient Journey at the Royal Berkshire Hospital
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Bronchoscopy
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Bronchoscopy - examination of your airways (English version)
Longkanker Nederland/YouTube
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Intro to Bronchoscopy: Risks, indications, contraindications and obtaining consent -- BAVLS
American Thoracic Society/YouTube
Sensitive content
This media may include sensitive content
Bronchoscopy
National Cancer Institute / Unknown Photographer
Sensitive content
This media may include sensitive content
What To Expect Before, During and After a Bronchoscopy
Cancer Research UK / Wikimedia Commons
Rigid bronchoscopy
JBARRETO
Small Cell Lung Cancer
Yale Rosen from USA
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This media may include sensitive content
What Does Bronchoscopy Show?
JHeuser
3:37
Diagnostic Bronchoscopy
Cleveland Clinic Abu Dhabi/YouTube
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EBUS guide for patients: bronchoscopy technique for chest abnormalities
astrazeneca/YouTube
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Electromagnetic Navigation Bronchoscopy
Gundersen Health System/YouTube
4:43
Robotic bronchoscopy - Mayo Clinic
Mayo Clinic/YouTube
9:06
Bronchoscopy Procedure, South West Acute Hospital
WesternTrust/YouTube
5:31
Using a Bronchial Scope for a Bronchoscopy at Christian Hospital in St. Louis, Missouri
Christian Hospital/YouTube
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Bronchoscopy & Lung Nodule Biopsy | Fox Chase Cancer Center
Fox Chase Cancer Center/YouTube
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All About Bronchoscopy
Singapore General Hospital/YouTube
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Bronchoscopic Foreign Body Removal -- BAVLS
American Thoracic Society/YouTube
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Sedation for Bronchoscopy (English version)
Longkanker Nederland/YouTube
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What happens during a bronchoscopy?
Top Doctors UK/YouTube
7:13
Bronchoscopy Patient Journey at the Royal Berkshire Hospital
A chest computed tomography (CT) scan is an imaging test that takes detailed pictures of the lungs and the inside of the chest. Computers combine the pictures to create a 3-D model showing the size, shape, and position of the lungs and structures in the chest.
A chest computed tomography (CT) scan is an imaging test that takes detailed pictures of the lungs and the inside of the chest. Computers combine the pictures to create a 3-D model showing the size, shape, and position of the lungs and structures in the chest.
{"label":"CT chest reference range","description":"A chest CT (computed tomography) scan is an imaging test that takes detailed pictures of the lungs and the inside of the chest. Computers combine the pictures to create a 3D model showing the size, shape, and position of the lungs and structures in the chest.","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A chest CT scan provides detailed pictures of the size, shape, and position of your lungs and other structures in your chest. A normal chest CT means your chest appears normal.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal chest CT scan may show any abnormality regarding the size, shape, and position of the lungs and structures in the chest.","conditions":["Heart failure","Pneumonia","Tuberculosis","Lung cancer","Sarcoidosis","Pleural effusion","Pulmonary embolism","Emphysema","Lung scarring"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
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health.
Your result is Normal.
A chest CT scan provides detailed pictures of the size, shape, and position of your lungs and other structures in your chest. A normal chest CT means your chest appears normal.
Related conditions
A chest CT scan is a more detailed type of chest X-ray. This painless imaging test takes many detailed pictures, called slices, of your lungs and the inside of your chest. Computers can combine these pictures to create three-dimensional (3D) models to help show the size, shape, and position of your lungs and structures in your chest.
This imaging test is often done to follow up on abnormal findings from earlier chest x rays. A chest CT scan also can help determine the cause of lung symptoms such as shortness of breath or chest pain, or check to see if you have certain lung problems such as a tumor, excess fluid around the lungs that is known as pleural effusion, pulmonary embolism, emphysema, tuberculosis, and pneumonia.
A chest CT scan provides detailed pictures of the size, shape, and position of your lungs and other structures in your chest. Doctors use this test to:
Follow up on abnormal results from standard chest x rays.
Find the cause of lung symptoms, such as shortness of breath or chest pain.
Find out whether you have a lung problem, such as a tumor, excess fluid around the lungs, or a pulmonary embolism (a blood clot in the lungs). The test also is used to check for other conditions, such as tuberculosis, emphysema, and pneumonia.
Your doctor may recommend a chest CT scan if you have symptoms of lung problems, such as chest pain or trouble breathing. The scan can help find the cause of the symptoms.
A chest CT scan looks for problems such as tumors, excess fluid around the lungs, and pulmonary embolism (a blood clot in the lungs). The scan also checks for other conditions, such as tuberculosis, emphysema, and pneumonia.
Your doctor may recommend a chest CT scan if a standard chest x ray doesn't help diagnose the problem. The chest CT scan can:
Provide more detailed pictures of your lungs and other chest structures than a standard chest x ray
Find the exact location of a tumor or other problem
Show something that isn't visible on a chest x ray
Your chest CT scan may be done in a medical imaging facility or hospital. The CT scanner is a large, tunnel-like machine that has a table. You will lie still on the table and the table will slide into the scanner. Talk to your doctor if you are uncomfortable in tight or closed spaces to see if you need medicine to relax you during the test. You will hear soft buzzing or clicking sounds when you are inside the scanner and the scanner is taking pictures. You will be able to hear from and talk to the technician performing the test while you are inside the scanner. For some diagnoses, a contrast dye, often iodine-based, may be injected into a vein in your arm before the imaging test. This contrast dye highlights areas inside your chest and creates clearer pictures. You may feel some discomfort from the needle or, after the contrast dye is injected, you may feel warm briefly or have a temporary metallic taste in your mouth.
Wear loose-fitting, comfortable clothing for the test. Sometimes the CT scan technician (a person specially trained to do CT scans) may ask you to wear a hospital gown. You also may want to avoid wearing jewelry and other metal objects. You'll be asked to take off any jewelry, eyeglasses, and metal objects that might interfere with the test. You may be asked to remove hearing aids and dentures as well. Let the technician know if you have any body piercing on your chest.
Tell your doctor whether you're pregnant or may be pregnant. If possible, you should avoid unnecessary radiation exposure during pregnancy. This is because of the concern that radiation may harm the fetus.
Chest CT scans have some risks. In rare instances, some people have an allergic reaction to the contrast dye. There is a slight risk of cancer, particularly in growing children, because the test uses radiation. Although the amount of radiation from one test is usually less than the amount of radiation you are naturally exposed to over three years, patients should not receive more CT scans than the number that clinical guidelines recommend. Another risk is that chest CT scans may detect an incidental finding, which is something that doesn’t cause symptoms but now may require more tests after being found.
Talk to your doctor and the technicians performing the test about whether you are or could be pregnant. If the test is not urgent, they may have you wait to do the test until after your pregnancy. If it is urgent, the technicians will take extra steps to protect your baby during this test. Let your doctor know if you are breastfeeding because contrast dye can pass into your breast milk. If you must have contrast dye injected, you may want to pump and save enough breast milk for one to two days after your test or you may bottle-feed your baby for that time.
https://www.nhlbi.nih.gov/health-topics/chest-ct-scan [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003788.htm [accessed on Aug 25, 2021]
Additional Materials (50)
Pleural empyema
CT chest showing large right sided hydro-pneumothorax from pleural empyema. Arrows A: air, B: fluid
Image by Amit Banga, GC Khilnani, SK Sharma1, AB Dey, Naveet Wig and Namrata Banga
How Are Pleurisy and Other Pleural Disorders Diagnosed?
CT with the identification of underlying lung lesion: an apical bulla.
Image by Robertolyra
How Are Pleurisy and Other Pleural Disorders Treated?
Right-sided pneumothorax (right side of image) on CT scan of the chest with chest tube in place.
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Chest Radiograph
Chest X-Ray : Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
What To Expect During a Coronary Calcium Scan
3D reconstruction of the thin multislice CT, covering human heart and lungs
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Incision for Open-Chest Bypass Surgery
Open-chest bypass surgery requires the surgeon to make an incision down the center of the chest, along the breastbone. The rib cage is spread open to expose the heart.
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A child's guide to hospital: CT Chest
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Coronary CT angiography of coronary arteries
Researchers have found that anti-inflammatory biologic therapies used to treat moderate to severe psoriasis can significantly reduce coronary inflammation in patients with the chronic skin condition. Scientists said the findings are particularly notable because of the use of a novel imaging biomarker, the perivascular fat attenuation index (FAI), that was able to measure the effect of the therapy in reducing the inflammation.
The study published online in JAMA Cardiology, has implications not just for people with psoriasis, but for those with other chronic inflammatory diseases, such as lupus and rheumatoid arthritis. These conditions are known to increase the risk for heart attacks and strokes. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
In this image: Coronary CT angiography image of the coronary arteries depicting the perivascular fat attenuation index before and after biologic therapy at one-year follow-up for patients with excellent response to biologic therapy.
Image by Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary CT
Coronary CT
Image by Bác sĩ Nguyễn Minh Đức
CT of the blood vessels and heart
CT of the blood vessels and heart
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Chest CT showing pulmonary sequestration
chest CT: diagnosis is pulmonary sequestration
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Scimitar syndrome chest CT
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/Wikimedia
Having a Cardiac CT Scan in Hospital
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What to Expect from a CT Exam with Contrast
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Protocoling chest CTs
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Cardiac CT scan
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What is it like to get a CT Scan with Contrast?
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Thorax with Healthy Heart
3D visualization based on scanned human data of a healthy heart in the thorax.
Image by TheVisualMD
Heart and Lungs
The heart and lungs are the primary contents of the thorax. They are interconnected with very large blood vessels. The heart sends oxygen-poor blood through the pulmonary arteries to the lungs, which oxygenate it and return it to the heart through the pulmonary veins. The pulmonary arteries arise from one large pulmonary trunk, and then begin branching exponentially once they enter the lungs in order to reach the functional respiratory units and pick up oxygen. The smallest pulmonary veins then take the oxygenated blood backwards through the lungs and empty into the back of the heart through four larger pulmonary veins. The oxygen-rich blood is then pumped by the heart out into the body through the aorta. Deoxygenated blood from body tissues returns to the heart through the superior and inferior vena cava and the cardiac cycle repeats continuously. The pulmonary veins and arteries are the only case where arteries carry deoxygenated blood and veins carry blood that has been oxygenated.
Image by TheVisualMD
Thorax with Muscle Involved in Respiration
3D visualization of an anterior view of the muscles involved in respiration. The primary job of the thorax is to promote movements necessary for breathing. Three muscles of the thorax assist in this function; the external intercostals, internal intercostals and diaphragm. The intercostals do the job of lifting the ribs up and pulling them outward, which in turn enlarges the lungs. As the lungs expand, the pressure inside them is reduced, and they suck in air. During extreme inhalation, the neck muscles also contract. During inhalation, the diaphragm contracts and pushes downward; during exhalation, it relaxes and is pushed up into a dome shape by the lower digestive organs, compressing the lungs. As pressure rises in the chest cavity, exhale occurs, pressure is equalized and the cycle restarts.
Image by TheVisualMD
Thorax with Muscle Involved in Respiration
3D visualization of an inferior view of the muscles involved in respiration. The primary job of the thorax is to promote movements necessary for breathing. Three muscles of the thorax assist in this function; the external intercostals, internal intercostals and diaphragm. The intercostals do the job of lifting the ribs up and pulling them outward, which in turn enlarges the lungs. As the lungs expand, the pressure inside them is reduced, and they suck in air. During extreme inhalation, the neck muscles also contract. During inhalation, the diaphragm contracts and pushes downward; during exhalation, it relaxes and is pushed up into a dome shape by the lower digestive organs, compressing the lungs. As pressure rises in the chest cavity, exhalation occurs, pressure is equalized and the cycle restarts.
Image by TheVisualMD
Thorax with visible Lung and Heart
3D visualization of a posterior view of the lungs and heart reconstructed from scanned human data. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Female Thorax Showing Breast
Visualization based on scanned human data of an anterior view of female breast.
Image by TheVisualMD
Male Thorax with Visible Heart
Visualization of male heart. The nerve supply of the heart is emphasized specifically the cardiac plexus. The plexus which rest around the base of the heart, mainly in the epicardium, is formed by cardiac branches from the vagus nerves and the sympathetic trunks and ganglia.
Image by TheVisualMD
Thorax with Heart and Lung
3D visualization of an anterior view of the lungs and heart reconstructed from scanned human data. The cone-shaped lungs occupy most of the thoracic cavity. Each lung is suspended in its own pleural cavity and connected to the mediastinum (which houses the heart) by its root which is made up of vascular and bronchial attachments. The anterior, lateral and posterior surfaces of the lung are in close contact with the ribs and form a continuously curving surface called the costal surface. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Cross Section of Human Thorax. Liver in bottom Left
Cross Section of Human Thorax. Liver in bottom Left
Image by TheVisualMD
Male Thorax Showing Trachea and Lung
3D visualization of an anterior view of the lungs and heart reconstructed from scanned human data. De-oxygenated red blood cells are sent by the right side of the heart through the pulmonary artery into the vessels of the lungs to be refilled with oxygen for their next circuit through the body. The blood is carried through the lung tissues, where it exchanges its carbon dioxide for oxygen in the alveoli. It is then returned through the pulmonary veins to the left side of the heart and sent out to the rest of the body. The pulmonary artery carries away the deoxygenated blood, which returns fully oxygenated through the pulmonary vein.
Image by TheVisualMD
Thoracic Aneurysm in the Aorta
Aneurysms that occur in the part of the aorta that is higher in the chest are called thoracic aortic aneurysms. Aortic aneurysms often grow slowly and usually without any symptoms therefore making them difficult to detect
Image by TheVisualMD
Ventilation/perfusion scan
subFusion processing applied to a SPECT lung ventilation-perfusion scan.
Image by KieranMaher at English Wikibooks
Bronchi and Bronchiole of Lung
3D visualization of an inferior view of a transverse section of the thorax, highlighting the lungs, reconstructed from scanned human data. The trachea, cardiac impression, and transverse sections of the thoracic aorta and esophagus are clearly illustrated. The bronchial tree is also visible. When air is inhaled into the lungs, it flows through large tubes called bronchi, branches into smaller tubes known as bronchioles, and ends up in the thousands of small pouches that are the alveoli. This is where the oxygen is transferred from the air into the bloodstream. Each alveolar sac, or air sac, is surrounded by a bed of capillaries, and the walls between the lung and the capillary are extremely thin. The walls are so delicate, in fact, that the inhaled oxygen can seep from the air sacs to bind to the hemoglobin in the blood, while the carbon dioxide and other waste gasses leave the blood and diffuse into the lungs where they can be exhaled.
Image by TheVisualMD
Chest Pain
Angina
Image by TheVisualMD
Chest Pain
Chest Pain
Image by TheVisualMD
Chest Pain or Tightness
Image by TheVisualMD
CT scanner
A view of the CT scanner in the new Fort Belvoir Community Hospital. The hospital, still under construction, is a 2005 Base Realignment and Closure project, and is scheduled to open later this year.
Image by Official Navy Page from United States of America MC2 Todd Frantom/U.S. Marine Corps
Illustration of 3 X-ray images and a patient entering a CT scanner
Radiation can be dangerous, but it can also save lives. When you’re faced with a medical test that uses radiation, don’t let fear get in your way. Learn about the risks and benefits, and know what questions to ask.
Image by NIH News in Health
Drawing of a computerized tomography scanner with a health care professional looking on a computer screen as a patient lies inside the scanner
CT scan.
Image by NIDDK Image Library
Advanced CT Scanning
An NIH Clinical Center study participant receives a scan in the Photon-Counting CT scanner.
Image by NIH Clinical Center
CAT Scan
A computer-assisted tomographic (CAT) scanner, with a Caucasian female technician working at a screen and behind a glass wall. A patient is on a table and being tested by the CAT scanner. The lighting is very subdued. This new technology revolutionized detection of brain tumors.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Virtual Colonoscopy Slice of CT Data
Virtual colonoscopy is a new imaging technology that uses computed tomography (CT) images to look for polyps and cancer in the colon. A computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Pleural empyema
Amit Banga, GC Khilnani, SK Sharma1, AB Dey, Naveet Wig and Namrata Banga
How Are Pleurisy and Other Pleural Disorders Diagnosed?
Robertolyra
How Are Pleurisy and Other Pleural Disorders Treated?
en:User:Clinical Cases
Chest Radiograph
TheVisualMD
What To Expect During a Coronary Calcium Scan
Semnic
Incision for Open-Chest Bypass Surgery
TheVisualMD
4:22
A child's guide to hospital: CT Chest
The Royal Children's Hospital Melbourne/YouTube
1:50
What is it like to have a CT scan? | Cancer Research UK
Cancer Research UK/YouTube
Coronary CT angiography of coronary arteries
Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary CT
Bác sĩ Nguyễn Minh Đức
CT of the blood vessels and heart
Bác sĩ Nguyễn Minh Đức
Chest CT showing pulmonary sequestration
RadsWiki
Scimitar syndrome chest CT
Matthew Cham, MD
/Wikimedia
4:59
Having a Cardiac CT Scan in Hospital
Oxford AHSN/YouTube
2:33
What to Expect from a CT Exam with Contrast
RAYUS Radiology™/YouTube
7:48
Protocoling chest CTs
Thoracic Radiology/YouTube
1:44
Low Dose CT Scans to Look for Lung Cancer
Lee Health/YouTube
8:27
Lung Cancer Screening (LCS)
Cleveland Clinic/YouTube
5:10
CT Scan of the Chest Explained Clearly - High Resolution CT Scan (HRCT)
MedCram - Medical Lectures Explained CLEARLY/YouTube
3:29
What to Expect: CT Scan | Cedars-Sinai
Cedars-Sinai/YouTube
17:21
How I Read a Chest CT
Thoracic Radiology/YouTube
8:46
Introduction to Computed Tomographic imaging of the Chest
Yale Radiology and Biomedical Imaging/YouTube
3:09
Lung Cancer Screening: The Life-saving CT Scan
RAYUS Radiology™/YouTube
2:19
How to prepare for a CT scan
Sunnybrook Hospital/YouTube
2:07
Using CT Scans to Screen for Lung Cancer
UConn Health/YouTube
5:04
Cardiac CT scan
UHP_NHS/YouTube
6:28
Real look at Chest, Abdomen and Pelvis CT Scan from Start to Finish.
Dumb Old Dad/YouTube
2:52
What is it like to get a CT Scan with Contrast?
STRIDE Project/YouTube
Thorax with Healthy Heart
TheVisualMD
Heart and Lungs
TheVisualMD
Thorax with Muscle Involved in Respiration
TheVisualMD
Thorax with Muscle Involved in Respiration
TheVisualMD
Thorax with visible Lung and Heart
TheVisualMD
Female Thorax Showing Breast
TheVisualMD
Male Thorax with Visible Heart
TheVisualMD
Thorax with Heart and Lung
TheVisualMD
Cross Section of Human Thorax. Liver in bottom Left
TheVisualMD
Male Thorax Showing Trachea and Lung
TheVisualMD
Thoracic Aneurysm in the Aorta
TheVisualMD
Ventilation/perfusion scan
KieranMaher at English Wikibooks
Bronchi and Bronchiole of Lung
TheVisualMD
Chest Pain
TheVisualMD
Chest Pain
TheVisualMD
Chest Pain or Tightness
TheVisualMD
CT scanner
Official Navy Page from United States of America MC2 Todd Frantom/U.S. Marine Corps
Illustration of 3 X-ray images and a patient entering a CT scanner
NIH News in Health
Drawing of a computerized tomography scanner with a health care professional looking on a computer screen as a patient lies inside the scanner
NIDDK Image Library
Advanced CT Scanning
NIH Clinical Center
CAT Scan
National Cancer Institute / Linda Bartlett (Photographer)
Virtual Colonoscopy Slice of CT Data
TheVisualMD
Bone Scan
Bone Scan
Also called: Bone Scintigraphy, Skeletal Scintigraphy, Nuclear Bone Scan, Bone Scan
A bone scan is a safe, effective, and painless way to make images of your bones using a compound containing a small amount of radioactivity injected into the bloodstream. The test helps find out if there is a tumor, infection, or other abnormality in your bone.
Bone Scan
Also called: Bone Scintigraphy, Skeletal Scintigraphy, Nuclear Bone Scan, Bone Scan
A bone scan is a safe, effective, and painless way to make images of your bones using a compound containing a small amount of radioactivity injected into the bloodstream. The test helps find out if there is a tumor, infection, or other abnormality in your bone.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
In a normal bone scan, the radioactive tracer is evenly spread among the bones. No areas of too much or too little tracer are seen, or areas of "cold" or "hot" spots.
Related conditions
A bone scan is a procedure to check for abnormal areas or damage in the bones. A very small amount of radioactive material is injected into a vein and travels through the blood. The radioactive material collects in the bones and is detected by a scanner (a special camera that takes pictures of the inside of the body). A bone scan may be used to diagnose bone tumors or cancer that has spread to the bone. It may also be used to help diagnose fractures, bone infections, or other bone problems.
A bone scan helps your doctor find out if there is a tumor, infection, or other abnormality in your bone. This scan is a safe, effective, and painless way to make pictures of your bones.
Before the procedure, a small amount of the compound (radioisotope) will be given to you by vein. Once you are in the imaging room, you will rest on a firm table with your head flat. During the scan, you will lie on your back. While you are in this position, a sensitive machine (called a scanner) will record the radiation given off by the radioisotope. Lie very still. Many pictures will be taken as the scanner moves from your head to your toes. After the scan, more pictures will be taken of your head and hands. Stay very still while these pictures are being taken.
There is no special preparation for this scan. You may eat and drink whatever you like.
There are no side effects, and the scan is painless. The only sensation you will feel will be the injection of the radioisotope in your vein.
Because it uses radioactivity, this scan is not performed in pregnant women. If you are pregnant or think you might be pregnant, please inform your doctor immediately so that a decision can be made about this scan.
Also, please inform your doctor immediately if you are breastfeeding. Some scans can be performed in breastfeeding women if they are willing to stop breastfeeding for a while.
https://www.cc.nih.gov/ccc/patient_education/procdiag/bonescan.pdf [accessed on Mar 21, 2019]
https://www.radiologyinfo.org/en/info.cfm?pg=bone-scan [accessed on Mar 21, 2019]
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/bone_scan_92,p07663 [accessed on Apr 01, 2019]
https://www.mayoclinic.org/tests-procedures/bone-scan/about/pac-20393136 [accessed on Apr 01, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (18)
Osteomyelitis
Osteomyelitis in both feet as seen on bone scan
Image by James Heilman, MD
Facing Forward: Life After Cancer Treatment
Facing Forward: Life After Cancer Treatment is for people who have completed cancer treatment. Family and friends may also want to read this booklet.
Document by National Cancer Institute (NCI)
Treatment Planning
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Image by TheVisualMD
Preventing Bone Complications From Bone Metastases
Video by For Your Life/YouTube
Impact of Bone Metastases on the Skeleton
Video by Amgen/YouTube
The Biology of Metastatic Bone Disease
Video by Amgen/YouTube
Having a bone scan | Cancer Research UK
Video by Cancer Research UK/YouTube
Introduction to Bone Biology
Video by Amgen/YouTube
bone-scan.swf
Video by Dr Amir Monir/YouTube
Bone Cancer
Video by Focus Medica/YouTube
Limb Lengthening and Reconstruction in Patient with Bone Cancer
Video by Hospital for Special Surgery/YouTube
Q&A: What is Ewing sarcoma? | Texas Children's Cancer and Hematology Centers
Video by Texas Children’s Hospital/YouTube
Ewing's Sarcoma - Mayo Clinic
Video by Mayo Clinic/YouTube
Ewing's Sarcoma, What Is It?
Video by EmpowHER/YouTube
Osteosarcoma - Mayo Clinic
Video by Mayo Clinic/YouTube
Treatment for Osterosarcoma at Boston Children's Hospital
Video by Boston Children's Hospital/YouTube
Chondrosarcoma, What Is This?
Video by EmpowHER/YouTube
Is Your Baby a Boy or a Girl? (Pregnancy Health Guru)
Video by Healthguru/YouTube
Osteomyelitis
James Heilman, MD
Facing Forward: Life After Cancer Treatment
National Cancer Institute (NCI)
Treatment Planning
TheVisualMD
4:17
Preventing Bone Complications From Bone Metastases
For Your Life/YouTube
2:21
Impact of Bone Metastases on the Skeleton
Amgen/YouTube
3:19
The Biology of Metastatic Bone Disease
Amgen/YouTube
1:35
Having a bone scan | Cancer Research UK
Cancer Research UK/YouTube
2:44
Introduction to Bone Biology
Amgen/YouTube
1:13
bone-scan.swf
Dr Amir Monir/YouTube
0:20
Bone Cancer
Focus Medica/YouTube
2:21
Limb Lengthening and Reconstruction in Patient with Bone Cancer
Hospital for Special Surgery/YouTube
5:41
Q&A: What is Ewing sarcoma? | Texas Children's Cancer and Hematology Centers
Texas Children’s Hospital/YouTube
9:01
Ewing's Sarcoma - Mayo Clinic
Mayo Clinic/YouTube
1:52
Ewing's Sarcoma, What Is It?
EmpowHER/YouTube
9:11
Osteosarcoma - Mayo Clinic
Mayo Clinic/YouTube
28:11
Treatment for Osterosarcoma at Boston Children's Hospital
Boston Children's Hospital/YouTube
1:13
Chondrosarcoma, What Is This?
EmpowHER/YouTube
1:29
Is Your Baby a Boy or a Girl? (Pregnancy Health Guru)
Healthguru/YouTube
Chest MRI Scan
Chest MRI Test
Also called: Chest MRI Scan, Chest Nuclear Magnetic Resonance, Chest NMR, MRI of the thorax, Thoracic MRI, Chest MRI
A chest MRI (magnetic resonance imaging) is an imaging test that uses radio waves, magnets, and a computer to create detailed pictures of the structures in your chest, including your chest wall, heart, and blood vessels.
Chest MRI Test
Also called: Chest MRI Scan, Chest Nuclear Magnetic Resonance, Chest NMR, MRI of the thorax, Thoracic MRI, Chest MRI
A chest MRI (magnetic resonance imaging) is an imaging test that uses radio waves, magnets, and a computer to create detailed pictures of the structures in your chest, including your chest wall, heart, and blood vessels.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A chest MRI evaluates blood flow, shows lymph nodes, blood vessels and the structures of the chest from many angles. A normal chest MRI means your chest area appears normal.
Related conditions
Chest MRI (magnetic resonance imaging) is a safe, noninvasive test. "Noninvasive" means that no surgery is done and no instruments are inserted into your body. This test creates detailed pictures of the structures in your chest, such as your chest wall, heart, and blood vessels.
Chest MRI uses radio waves, magnets, and a computer to create these pictures. The test is used to:
Look for tumors in the chest
Look at blood vessels, lymph (limf) nodes, and other structures in the chest
Help explain the results of other tests, such as a chest x ray or chest computed tomography (to-MOG-rah-fee) scan, also called a chest CT scan.
As part of some chest MRIs, a substance called contrast dye is injected into a vein in your arm. This dye allows the MRI to take more detailed pictures of the structures in your chest.
Chest MRI can provide detailed information to help your doctor diagnose lung problems such as a tumor or pleural disorder, blood vessel problems, or abnormal lymph nodes. Chest MRI can help explain the results of other imaging tests such as chest x rays and chest CT scans.
Your doctor may recommend chest MRI if he or she thinks you have a chest condition, such as:
A tumor
Problems in the blood vessels, such as an aneurysm (AN-u-rism) or blood clot
Abnormal lymph nodes
Another chest condition, such as a pleural disorder
Chest MRI also may be used to help explain the results of other tests, such as chest x ray and chest CT scan.
Researchers are exploring ways to use chest MRI to study blood flow in the lungs. The test may help detect early signs of pulmonary hypertension (PH). PH is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen.
Chest MRI may be done in a medical imaging facility or hospital. Before your test, a technician may inject a contrast dye into a vein in your arm to highlight your heart and blood vessels. You may feel some discomfort from the needle or have a cool feeling as the contrast dye is injected. The MRI machine is a large, tunnel-like machine that has a table. You will lie still on the table, and the table will slide into the machine. You will hear loud humming, tapping, and buzzing sounds when you are inside the machine as pictures of your chest are being taken. You will be able to hear from and talk to the technician performing the test while you are inside the machine. The technician may ask you to hold your breath for a few seconds during the test.
Your doctor or an MRI technician will ask you some questions before the test, such as:
Are you pregnant or do you think you could be? Generally, you shouldn't have a chest MRI if you're pregnant, especially during the first trimester. Sometimes, though, an MRI is needed to help diagnose a serious condition that may harm you or your baby. If you're pregnant, discuss the risks and benefits of an MRI with your doctor.
Have you had any surgery? If so, what kind?
Do you use transdermal patches (patches that stick to the skin) to take any of your medicines? Some medicine patches contain aluminum and other metals. These metals can cause skin burns during an MRI. Examples of transdermal patches are nicotine and fentanyl (medicine used for pain) patches.
Do you have any metal objects in your body, like metal screws or pins in a bone?
Do you have any medical devices in your body, such as a pacemaker, an implantable cardioverter defibrillator, cochlear (inner-ear) implants, or brain aneurysm clips? The strong magnets in the MRI machine can damage these devices.
Your answers will help your doctor decide whether you should have chest MRI.
Chest MRI has few risks. Unlike a CT scan or standard x ray, MRI doesn't use radiation or pose any risk of cancer. Rarely, the contrast dye used for some chest MRIs may cause an allergic reaction or worsen kidney function in people who have kidney disease.
The pictures from chest MRI may show a tumor, problems in the blood vessels (such as an aneurysm or blood clot), abnormal lymph nodes, or another chest condition (such as a pleural disorder).
https://www.nhlbi.nih.gov/health-topics/chest-mri [accessed on Feb 25, 2022]
https://medlineplus.gov/ency/article/003794.htm [accessed on Feb 25, 2022]
Additional Materials (23)
MRI and CT Scan the differences
Video by Vijayan Ragavan/YouTube
Having a Cardiac MRI scan
Video by Birmingham Women's and Children's NHS Trust/YouTube
Chest MRI – Valley Children’s Hospital
Video by ValleyChildrens/YouTube
What To Expect During Cardiac MRI
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Image by National Heart, Lung and Blood Institute / NIH
MRI Scans
Philips MRI in Sahlgrenska Universitetsjukhuset, Gothenburg, Sweden.
Image by Jan Ainali
Human Heart
Composited image profile of a heart as seen through various rendering techniques. With volume rendering software, slices of Magnetic Resonance Imagery (MRI), and Computer Tomography (CT) scans can be compiled to produce a three-dimensional (3D) model of an organ such as a heart. Models can be viewed in various ways. As individual slices, as is seen along the left or as enhanced color, gray scale volume and 3D transparency, as is seen along the right.
Image by TheVisualMD
Magnetic Resonance Angiography
Figure A shows the heart's position in the body and the location and angle of the MRI pictures shown in figure C. Figure B is an MRI angiogram, which is sometimes used instead of a standard angiogram. Figure C shows MRI pictures of a normal left ventricle (left image), a left ventricle damaged from a heart attack (middle image), and a left ventricle that isn't getting enough blood from the coronary arteries (right image).
Image by National Heart Lung and Blood Institute (NIH)
MRI Scans
Woman lying face down on breast MRI table, right breast visible, for MRI exam. Breast MRI tables have special padded recesses that the breasts hang into for imaging. MRIs don't expose the patient to radiation, as they use magnetic energy and radiowaves to produce hundreds of images of the breast from multiple angles. Breast MRIs use a contrast agent called gadolinium, injected through an intravenous line, that causes tumors to "light up" in the MRI image.
Image by ser:KasugaHuang
Cardiac Mri
Figure A shows the heart's position in the body and the location and angle of the MRI pictures shown in figure C. Figure B is an MRI angiogram, which is sometimes used instead of a standard angiogram. Figure C shows MRI pictures of a normal left ventricle (left image), a left ventricle damaged from a heart attack (middle image), and a left ventricle that isn't getting enough blood from the coronary arteries (right image).
Image by National Heart Lung and Blood Institute (NIH)
Enlarged right ventricle with poor function in a patient with repaired tetralogy of Fallot by CMR
Enlarged right ventricle with poor function in a patient with repaired tetralogy of Fallot by CMR
Image by Jccmoon (talk)
Cardiac MRI flow visualization
Cardiac MRI flow visualization
Image by Vasanawala
Cardiac MRI streamlines
Cardiac MRI streamlines visualization
Image by Vasanawala
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Image by Hellerhoff
Cardiac magnetic resonance imaging perfusion
Animated sagittal MRI slice of my beating heart
Image by Bionerd
Chest MRI
Video by MRI Arbil/YouTube
Diagnostic Imaging
MRI of the ThoraxSpecialized test,. like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
Imaging of the Heart With Contrast
Imaging of the Heart With Contrast
Image by TheVisualMD
Lumpectomy
Colorized MR of Breasts After Breast Conserving Surgery or Lumpectomy : Colorized breast MR of breasts, axial slice (horizontal view, as though seen from above). The breast on the right side of the image has had breast-conserving surgery, also called lumpectomy. This type of surgery removes the tumor, some breast tissue, and some lymph nodes, but preserves the chest muscles. The aim of the surgery is to take only as much tissue as is necessary to keep the chance of recurrence low, but to keep the breast looking as normal as possible.
Image by TheVisualMD
Aortic dissection
Aortic Dissection : CT of aortic dissection 1 descending aorta with dissection 2 left subclavian artery 3 ascending aorta
Image by Dr. Lars Grenacher (www.grenacher.de), uploaded by J. Heuser
Symptoms, Tests, and Diagnosis
Image by TheVisualMD
Breast MRI for Cancer Staging
Breast MRI for Cancer Staging
Image by TheVisualMD
Breast MRI (VIDEO)
Dr. Nora Jaskowiak of The University of Chicago Medical Center explains why Magnetic Resonance Imaging, or MRI, is a critical tool in her role as breast surgeon.
Image by TheVisualMD
PET/MR
Hybrid device for PET/MR diagnostics with a magnetic field strength of 3 Tesla.
Image by Tomáš Vendiš/Wikimedia
5:35
MRI and CT Scan the differences
Vijayan Ragavan/YouTube
3:55
Having a Cardiac MRI scan
Birmingham Women's and Children's NHS Trust/YouTube
1:58
Chest MRI – Valley Children’s Hospital
ValleyChildrens/YouTube
What To Expect During Cardiac MRI
National Heart, Lung and Blood Institute / NIH
MRI Scans
Jan Ainali
Human Heart
TheVisualMD
Magnetic Resonance Angiography
National Heart Lung and Blood Institute (NIH)
MRI Scans
ser:KasugaHuang
Cardiac Mri
National Heart Lung and Blood Institute (NIH)
Enlarged right ventricle with poor function in a patient with repaired tetralogy of Fallot by CMR
Jccmoon (talk)
Cardiac MRI flow visualization
Vasanawala
Cardiac MRI streamlines
Vasanawala
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Hellerhoff
Cardiac magnetic resonance imaging perfusion
Bionerd
13:24
Chest MRI
MRI Arbil/YouTube
Diagnostic Imaging
TheVisualMD
Imaging of the Heart With Contrast
TheVisualMD
Lumpectomy
TheVisualMD
Aortic dissection
Dr. Lars Grenacher (www.grenacher.de), uploaded by J. Heuser
Symptoms, Tests, and Diagnosis
TheVisualMD
Breast MRI for Cancer Staging
TheVisualMD
Breast MRI (VIDEO)
TheVisualMD
PET/MR
Tomáš Vendiš/Wikimedia
CYFRA 21-1 Test
CYFRA 21-1 Test
Also called: Cytokeratin fragment 21-1, Cytokeratin 19 fragment
The CYFRA 21-1 test detects fragments of a protein called cytokeratin 19 in a sample of your blood or body fluid. The cytokeratin 19 protein is expressed in certain types of cancer, especially in non-small cell lung cancer.
CYFRA 21-1 Test
Also called: Cytokeratin fragment 21-1, Cytokeratin 19 fragment
The CYFRA 21-1 test detects fragments of a protein called cytokeratin 19 in a sample of your blood or body fluid. The cytokeratin 19 protein is expressed in certain types of cancer, especially in non-small cell lung cancer.
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Use the slider below to see how your results affect your
health.
ng/mL
3.3
Your result is Normal.
Reference ranges can vary depending on the laboratory and the method used for testing. Decreasing concentrations of CYFRA 21-1 in non-small cell lung cancer indicates response to treatment.
Related conditions
The CYFRA 21-1 test is used as a tumor marker for lung cancer (meaning that if your results are high, there is a good chance that you have cancer). It can also be used to help predict the outcome (prognosis) of the disease and to monitor response to treatment. This test detects fragments of a protein called cytokeratin 19 in a sample of your blood or body fluid.
Your doctor may want to order this test if you have been diagnosed with a condition known as pleural effusion, which is the accumulation of fluid in your pleurae (the membranes that cover your chest cavity and lungs).
The primary goal of this test is to help distinguish benign from malignant causes of pleural effusion; however, it can also be used to monitor cancer treatment and to help predict the prognosis (outcome) of the disease.
Usually, a small amount of blood will be drawn from a vein in your arm by using a needle.
Less frequently, a procedure called thoracentesis is performed by a healthcare practitioner, usually in a hospital setting. In this procedure, a needle will be used to take a sample of the fluid in your pleurae after using a local anesthetic.
No preparations are needed. However, you should inform your healthcare practitioner if you are taking any over-the-counter or prescription medications, especially blood-thinners.
During the blood test, you may feel a little sting when the needle is inserted and extracted but otherwise is a quick procedure. You may also experience bruising and a little bleeding, as well as mild soreness for a short amount of time after the extraction.
During the thoracentesis procedure, you may feel an uncomfortable pressure and a little bleeding; furthermore, a complication called pneumothorax (air accumulation in the pleurae, pushing and collapsing the lung) might occur. You also have risks of getting an infection.
Normal values are:
Blood: less than 3.3 ng/mL.
Pleural liquid: less than 50 ng/mL.
Reference ranges can vary depending on the laboratory and the method used for testing.
Increased CYFRA 21-1 results are highly suggestive of malignancy, and further testing will be required. Other than lung cancer, high levels can be found in:
Malignant mesothelioma
Bladder cancer
Nasopharynx cancer
Esophagus cancer
Uterine cancer
Impaired lymphatic drainage
Pleural seeding of the tumor
Another test, known as carcinoembryonic antigen (CEA), is considered to be the most useful tumor marker. However, the combination of CEA and CYFRA 21-1 has shown a superior diagnostic value than any of these tests alone.
Evaluation of Cytokeratin 19 Fragment (CYFRA 21-1) as a Tumor Marker in Malignant Pleural Effusion | Japanese Journal of Clinical Oncology | Oxford Academic [accessed on Dec 05, 2018]
Carcinoembryonic antigen, squamous cell carcinoma antigen, CYFRA 21-1, and neuron-specific enolase in squamous cell lung cancer patients. — EDRN Public Portal [accessed on Dec 05, 2018]
Diagnostic Value of CYFRA 21-1, CEA, CA 19-9, CA 15-3, and CA 125 Assays in Pleural Effusions: Analysis of 116 Cases and Review of the Literature [accessed on Dec 05, 2018]
DEFINE_ME [accessed on Dec 05, 2018]
Prognostic and predictive value of CEA and CYFRA 21-1 levels in advanced non-small cell lung cancer patients treated with gefitinib or erlotinib [accessed on Dec 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Mediastinoscopy
Mediastinoscopy. A mediastinoscope is inserted into the chest through an incision above the breastbone to look for abnormal areas between the lungs.
Mediastinoscopy. A mediastinoscope is inserted into the chest through an incision above the breastbone to look for abnormal areas between the lungs.
Mediastinoscopy. A mediastinoscope is inserted into the chest through an incision above the breastbone to look for abnormal areas between the lungs. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a cutting tool. Tissue samples may be taken from lymph nodes on the right side of the chest and checked under a microscope for signs of cancer. In an anterior mediastinotomy (Chamberlain procedure), the incision is made beside the breastbone to remove tissue samples from the lymph nodes on the left side of the chest.
A procedure in which a mediastinoscope is used to examine the organs in the area between the lungs and nearby lymph nodes. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. The mediastinoscope is inserted into the chest through an incision above the breastbone. This procedure is usually done to get a tissue sample from the lymph nodes on the right side of the chest.
Fine-needle aspiration biopsy of the lung. The patient lies on a table that slides through the computed tomography (CT) machine, which takes x-ray pictures of the inside of the body. The x-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.
The removal of a small piece of lung tissue to be checked by a pathologist for cancer or other diseases. The tissue may be removed using a bronchoscope (a thin, lighted, tube-like instrument that is inserted through the trachea and into the lung). It may also be removed using a fine needle inserted through the chest wall, by surgery guided by a video camera inserted through the chest wall, or by an open biopsy. In an open biopsy, a doctor makes an incision between the ribs, removes a sample of lung tissue, and closes the wound with stitches.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Biopsy
Lung biopsy guided by computertomography: Lung cancer. Lung biopsy in a case of suspected lung cancer under control of computer tomography.
Image by Hellerhoff
Biopsy wrap, biopsy sponge, tissue processing cassette and biopsy bag
Items used for submitting specimens from gross examination in surgical pathology: (Biopsy) wrap, (biopsy) sponge, (tissue processing) cassette and (biopsy) bag.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
Ultrasound, Endoscopic (EUS), With Biopsy
Endoscopic ultrasound-guided fine-needle aspiration biopsy; drawing shows an endoscope with an ultrasound probe and biopsy needle inserted through the mouth and into the esophagus. Also shown are the lymph nodes near the esophagus and cancer in one lung. An inset shows the ultrasound probe locating the lymph nodes with cancer and the biopsy needle removing tissue from one of the lymph nodes near the esophagus.
Endoscopic ultrasound-guided fine-needle aspiration biopsy. An endoscope that has an ultrasound probe and a biopsy needle is inserted through the mouth and into the esophagus. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the lymph nodes near the esophagus. The sonogram helps the doctor see where to place the biopsy needle to remove tissue from the lymph nodes. This tissue is checked under a microscope for signs of cancer.
Pulmonary TB | Infectious diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
4:43
Robotic bronchoscopy - Mayo Clinic
Mayo Clinic/YouTube
Sputum Cytology
Gram Stained Smear of Sputum for Observation
Image by Ajay Kumar Chaurasiya/Wikimedia
Gram Stained Smear of Sputum for Observation
Gram Stained Smear of Sputum for Observation
Image by Ajay Kumar Chaurasiya/Wikimedia
Sputum Cytology
Examination under a microscope of cells found in sputum (mucus and other matter brought up from the lungs by coughing). The test checks for abnormal cells, such as lung cancer cells.
Source: National Cancer Institute (NCI)
Additional Materials (13)
Sputum Cytology
Sputum cytology is a test that examines a sample of mucus coughed up from the lungs for abnormal cells. The microscopic assessment of individual cells or cell clusters in sputum has been proven useful in detecting lung cancer at an early stage. The test is most effective for finding malignancies that originate in the major airways of the lungs; it is less effective for cancers found in other parts of the lungs or those that start elsewhere in the body and spread to lung tissue.
Image by TheVisualMD
Mycobacterium tuberculosis
This illustration depicts a photomicrograph of a sputum specimen, and revealed the presence of numerous, Mycobacterium tuberculosis bacteria. This bacterium can attack any part of the body, though usually the lungs, causing tuberculosis, and is spread through inhalation of infected sputum from a coughing, or sneezing individual.
Image by CDC
Haemophilus influenzae sputum 1000x edited
Sputum Gram stain at 1000x magnification. The sputum is from a person with Haemophilus influenzae pneumonia, and the Gram negative coccobacilli are visible with a background of neutrophils, which are white blood cells indicative of acute inflammation.
Image by Microman12345/Wikimedia
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Image by Bobjgalindo
Mycobacterium leprae in Ziehl-Neelsen stained smear of sputum
Mycobacterium leprae in Ziehl-Neelsen stained smear of sputum at magnification of 4000X
Image by Ajay Kumar Chaurasiya/Wikimedia
Mycobacterium tuberculosis
This illustration depicts a photomicrograph of a sputum specimen, processed using the Ziehl-Neelsen staining method, and revealed the presence of numerous, Mycobacterium tuberculosis bacteria. This bacterium can attack any part of the body, though usually the lungs, causing tuberculosis, and is spread through inhalation of infected sputum from a coughing, or sneezing individual.
Image by CDC
Sputum Cytology | Labs
Video by Medicosis Perfectionalis/YouTube
Sputum Culture and Sensitivity | Sputum Sample | Labs 🧪
Video by Medicosis Perfectionalis/YouTube
Induced Sputum Collection - English Version
Video by Global Tuberculosis Institute/YouTube
SPUTUM PROCESSING
Video by UCSF Documents & Media Photography/YouTube
Airway Hyperresponsiveness - Sputum Analysis
Video by Demystifying Medicine McMaster/YouTube
How to Collect Sputum Samples
Video by Eastern Ontario Health Unit/Bureau de santé de l’est de l’Ontario/YouTube
Sputum Sample Collection | OSCE Guide
Video by Geeky Medics/YouTube
Sputum Cytology
TheVisualMD
Mycobacterium tuberculosis
CDC
Haemophilus influenzae sputum 1000x edited
Microman12345/Wikimedia
Staph sputum - Staphylococcus aureus: Gram positive cocci under the microscope (40x) from a sputum sample.
Bobjgalindo
Mycobacterium leprae in Ziehl-Neelsen stained smear of sputum
Ajay Kumar Chaurasiya/Wikimedia
Mycobacterium tuberculosis
CDC
4:25
Sputum Cytology | Labs
Medicosis Perfectionalis/YouTube
9:57
Sputum Culture and Sensitivity | Sputum Sample | Labs 🧪
Medicosis Perfectionalis/YouTube
4:00
Induced Sputum Collection - English Version
Global Tuberculosis Institute/YouTube
6:47
SPUTUM PROCESSING
UCSF Documents & Media Photography/YouTube
2:56
Airway Hyperresponsiveness - Sputum Analysis
Demystifying Medicine McMaster/YouTube
3:04
How to Collect Sputum Samples
Eastern Ontario Health Unit/Bureau de santé de l’est de l’Ontario/YouTube
1:50
Sputum Sample Collection | OSCE Guide
Geeky Medics/YouTube
Stages
Stage 1A and 1B lung cancer
Stage 2A lung cancer
Option for stage 2Bb lung cancer
Stage 3A lung cancer - Diagram 1 of 3
Stage 3A lung cancer - Diagram 2 of 3
Stage 3A lung cancer - Diagram 3 of 3
Stage 3B lung cancer - Diagram 1 of 2
Diagram 2 of 2 showing stage 3B lung cancer
1
2
3
4
5
6
7
8
Stages - Lung Cancer
Interactive by Cancer Research UK / Wikimedia Commons
Stage 1A and 1B lung cancer
Stage 2A lung cancer
Option for stage 2Bb lung cancer
Stage 3A lung cancer - Diagram 1 of 3
Stage 3A lung cancer - Diagram 2 of 3
Stage 3A lung cancer - Diagram 3 of 3
Stage 3B lung cancer - Diagram 1 of 2
Diagram 2 of 2 showing stage 3B lung cancer
1
2
3
4
5
6
7
8
Stages - Lung Cancer
Interactive by Cancer Research UK / Wikimedia Commons
Stages of Small Cell Lung Cancer
KEY POINTS
After small cell lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the chest or to other parts of the body.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
The following stages are used for small cell lung cancer:
Limited-stage small cell lung cancer
Extensive-stage small cell lung cancer
Small cell lung cancer can recur (come back) after it has been treated.
After small cell lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the chest or to other parts of the body.
The process used to find out if cancer has spread within the chest or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Some of the tests used to diagnose small cell lung cancer are also used to stage the disease. (See the General Information section.)
Other tests and procedures that may be used in the staging process include the following:
MRI (magnetic resonance imaging) of the brain: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the brain, chest or upper abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A PET scan and CT scan may be done at the same time. This is called a PET-CT.
Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if small cell lung cancer spreads to the brain, the cancer cells in the brain are actually lung cancer cells. The disease is metastatic small cell lung cancer, not brain cancer.
The following stages are used for small cell lung cancer:
Limited-stage small cell lung cancer
In limited-stage, cancer is in the lung where it started and may have spread to the area between the lungs or to the lymph nodes above the collarbone.
Extensive-stage small cell lung cancer
In extensive-stage, cancer has spread beyond the lung or the area between the lungs or the lymph nodes above the collarbone to other places in the body.
Small cell lung cancer can recur (come back) after it has been treated.
The cancer may come back in the chest, central nervous system, or in other parts of the body.
Source: National Cancer Institute (NIH)
Additional Materials (8)
Small Cell Lung Cancer
Micrograph of small cell carinoma of the lung, also small cell lung cancer.
Image by Nephron
Lung Cancer Staging Explained Clearly by MedCram.com
Video by MedCram - Medical Lectures Explained CLEARLY/YouTube
Stage 1 and Stage 2 Lung Cancer
Video by Cleveland Clinic/YouTube
Going from Stage IV Lung Cancer to Clean Scans
Video by Atrium Health/YouTube
Lung Cancer: Staging Presentation
Video by Demystifying Medicine/YouTube
Staging of Lung Cancer
Video by You and Lung Cancer/YouTube
Low Dose CT Screening for Lung Cancer Video – Brigham and Women’s Hospital
Video by Brigham And Women's Hospital/YouTube
Stage 3 and Stage 4 Lung Cancer
Video by Cleveland Clinic/YouTube
Small Cell Lung Cancer
Nephron
13:09
Lung Cancer Staging Explained Clearly by MedCram.com
MedCram - Medical Lectures Explained CLEARLY/YouTube
2:23
Stage 1 and Stage 2 Lung Cancer
Cleveland Clinic/YouTube
3:01
Going from Stage IV Lung Cancer to Clean Scans
Atrium Health/YouTube
5:32
Lung Cancer: Staging Presentation
Demystifying Medicine/YouTube
3:39
Staging of Lung Cancer
You and Lung Cancer/YouTube
4:46
Low Dose CT Screening for Lung Cancer Video – Brigham and Women’s Hospital
Brigham And Women's Hospital/YouTube
2:11
Stage 3 and Stage 4 Lung Cancer
Cleveland Clinic/YouTube
Treatment
Lobectomy of Lung
Bilobectomy of Lung
Pneumonectomy of Lung
1
2
3
Types of Lung Surgery
Interactive by Cancer Research UK
Lobectomy of Lung
Bilobectomy of Lung
Pneumonectomy of Lung
1
2
3
Types of Lung Surgery
There are different types of lung surgery: 1- Removing one lobe (lobectomy); 2- Removing two lobes (bilobectomy); 3- Removing the whole lung (pneumonectomy).
Interactive by Cancer Research UK
Treatment of Small Cell Lung Cancer
Treatment Option Overview
KEY POINTS
There are different types of treatment for patients with small cell lung cancer.
Six types of standard treatment are used:
Surgery
Chemotherapy
Radiation therapy
Immunotherapy
Laser therapy
Endoscopic stent placement
New types of treatment are being tested in clinical trials.
Treatment for small cell lung cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with small cell lung cancer.
Different types of treatment are available for patients with small cell lung cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
The following types of treatment are used:
Surgery
Surgery may be used if the cancer is found in one lung and in nearby lymph nodes only. Because this type of lung cancer is usually found in both lungs, surgery alone is not often used. During surgery, the doctor will also remove lymph nodes to find out if they have cancer in them. Sometimes, surgery may be used to remove a sample of lung tissue to find out the exact type of lung cancer.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. External radiation therapy is used to treat small cell lung cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life. Radiation therapy to the brain to lessen the risk that cancer will spread to the brain may also be given.
Immunotherapy
Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.
Immune checkpoint inhibitor therapy is a type of immunotherapy used to treat some patients with advanced small cell lung cancer.
Types of immune checkpoint inhibitor therapy include:
PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. Atezolizumab and durvalumab are types of PD-L1 inhibitors.
Laser therapy
Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.
Endoscopic stent placement
An endoscope is a thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may be used to place a stent in a body structure to keep the structure open. An endoscopic stent can be used to open an airway blocked by abnormal tissue.
New types of treatment are being tested in clinical trials.
Treatment for small cell lung cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Source: National Cancer Institute (NIH)
Additional Materials (26)
Chemotherapy
Variety of chemotherapy drugs in a dripping IV bottle.
Image by Bill Branson (Photographer)
Combined Therapies for Small-Cell Lung Cancer
Video by NEJMvideo/YouTube
Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)
Video by You and Lung Cancer/YouTube
Current therapeutic landscape for small-cell lung cancer
Video by VJOncology/YouTube
Uses of radiotherapy for small cell lung cancer
Video by VJOncology/YouTube
Immunotherapy Treatments for Non-Small Cell Lung Cancer (NSCLC)
Video by You and Lung Cancer/YouTube
Immunotherapy and Antibodies | Slaying Lung Cancer
Video by Johns Hopkins Medicine/YouTube
When Is Lung Cancer Considered Inoperable?
Video by HenryFordTV/YouTube
Lung cancer treatment | Respiratory system diseases | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Lisa’s Story: Living with lung cancer
Video by Lung Foundation Australia/YouTube
Combination Therapy Increases Survival in Metastatic Lung Cancer Patients
Video by NYU Langone Health/YouTube
Battling Lung Cancer with Immunotherapy
Video by Johns Hopkins Medicine/YouTube
Facing Lung Cancer: Surgery—What to Expect?
Video by American Lung Association/YouTube
Immunotherapy: New Hope for Lung Cancer Treatment
Video by American Lung Association/YouTube
Precision Medicine for Lung Cancer
Video by National Cancer Institute/YouTube
Surviving With Metastatic Lung Cancer Thanks to Research
Video by American Association for Cancer Research/YouTube
Treatments for lung cancer | Cancer Research UK
Video by Cancer Research UK/YouTube
Treatment and Management of Small Cell Lung Cancer (SCLC)
Video by You and Lung Cancer/YouTube
The future of small cell lung cancer care
Video by Roche/YouTube
Small cell lung cancer may respond to combination of immunotherapy and targeted therapy
Video by MD Anderson Cancer Center/YouTube
A Win for Small–Cell Lung Cancer: IMPOWER 133
Video by OncLiveTV/YouTube
Chemoradiation and immunotherapy for patients with small cell lung cancer
Video by Winship Cancer Institute of Emory University/YouTube
Frontline Therapy Approaches for Small Cell Lung Cancer
Video by OncLiveTV/YouTube
Advice for Patients With Small Cell Lung Cancer
Video by curetoday/YouTube
Rovalpituzumab in small cell lung cancer (SCLC)
Video by VJOncology/YouTube
Unmet needs in radiotherapy for small cell lung cancer
Video by VJOncology/YouTube
Chemotherapy
Bill Branson (Photographer)
1:58
Combined Therapies for Small-Cell Lung Cancer
NEJMvideo/YouTube
2:52
Immunotherapy Treatments for Small Cell Lung Cancer (SCLC)
You and Lung Cancer/YouTube
2:56
Current therapeutic landscape for small-cell lung cancer
VJOncology/YouTube
7:03
Uses of radiotherapy for small cell lung cancer
VJOncology/YouTube
3:30
Immunotherapy Treatments for Non-Small Cell Lung Cancer (NSCLC)
You and Lung Cancer/YouTube
4:29
Immunotherapy and Antibodies | Slaying Lung Cancer
Johns Hopkins Medicine/YouTube
0:44
When Is Lung Cancer Considered Inoperable?
HenryFordTV/YouTube
8:12
Lung cancer treatment | Respiratory system diseases | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
4:27
Lisa’s Story: Living with lung cancer
Lung Foundation Australia/YouTube
2:22
Combination Therapy Increases Survival in Metastatic Lung Cancer Patients
NYU Langone Health/YouTube
3:29
Battling Lung Cancer with Immunotherapy
Johns Hopkins Medicine/YouTube
4:02
Facing Lung Cancer: Surgery—What to Expect?
American Lung Association/YouTube
3:03
Immunotherapy: New Hope for Lung Cancer Treatment
American Lung Association/YouTube
3:52
Precision Medicine for Lung Cancer
National Cancer Institute/YouTube
5:07
Surviving With Metastatic Lung Cancer Thanks to Research
American Association for Cancer Research/YouTube
1:25
Treatments for lung cancer | Cancer Research UK
Cancer Research UK/YouTube
3:13
Treatment and Management of Small Cell Lung Cancer (SCLC)
You and Lung Cancer/YouTube
4:12
The future of small cell lung cancer care
Roche/YouTube
1:51
Small cell lung cancer may respond to combination of immunotherapy and targeted therapy
MD Anderson Cancer Center/YouTube
6:33
A Win for Small–Cell Lung Cancer: IMPOWER 133
OncLiveTV/YouTube
2:03
Chemoradiation and immunotherapy for patients with small cell lung cancer
Winship Cancer Institute of Emory University/YouTube
4:37
Frontline Therapy Approaches for Small Cell Lung Cancer
OncLiveTV/YouTube
3:59
Advice for Patients With Small Cell Lung Cancer
curetoday/YouTube
1:56
Rovalpituzumab in small cell lung cancer (SCLC)
VJOncology/YouTube
1:38
Unmet needs in radiotherapy for small cell lung cancer
VJOncology/YouTube
Extensive-Stage Small Cell Lung Cancer
Non-small cell lung cancer in a 54-year-old woman
Image by Oregon State University
Non-small cell lung cancer in a 54-year-old woman
This photo provided by Naturopathic Doctor News and Review shows non-small cell lung cancer in a 54-year-old woman.
Image by Oregon State University
Treatment of Extensive-Stage Small Cell Lung Cancer
Treatment of extensive-stage small cell lung cancer may include the following:
Immune checkpoint inhibitor therapy and combination chemotherapy.
Combination chemotherapy.
Radiation therapy to the brain, spine, bone, or other parts of the body where the cancer has spread, as palliative therapy to relieve symptoms and improve quality of life.
Radiation therapy to the chest may be given to patients who respond to chemotherapy.
Radiation therapy to the brain may be given to patients who have had a complete response, to prevent the spread of cancer to the brain.
Clinical trials of new treatments.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Source: National Cancer Institute (NCI)
Additional Materials (4)
Does Surgery Cause Lung Cancer to Spread? The Facts.
Video by Patient Empowerment Network/YouTube
Stage 3 and Stage 4 Lung Cancer
Video by Cleveland Clinic/YouTube
Surviving With Metastatic Lung Cancer Thanks to Research
Video by American Association for Cancer Research/YouTube
Lung Cancer or Metastasis to Lung?
Video by Cleveland Clinic/YouTube
2:29
Does Surgery Cause Lung Cancer to Spread? The Facts.
Patient Empowerment Network/YouTube
2:11
Stage 3 and Stage 4 Lung Cancer
Cleveland Clinic/YouTube
5:07
Surviving With Metastatic Lung Cancer Thanks to Research
American Association for Cancer Research/YouTube
9:20
Lung Cancer or Metastasis to Lung?
Cleveland Clinic/YouTube
Recurrent Small Cell Lung Cancer
Small Cell Carcinoma, Pleural Fluid Cytology
Image by euthman
Small Cell Carcinoma, Pleural Fluid Cytology
63-year-old woman with smoking history presented with opacification of one lung lobe, markedly enlarged thoracic lymph nodes, and radiographic evidence of pleural and systemic metastases. Pap stain of Cytospin preparations showed several groups like the one pictured here: small dark cells with prominent nuclear molding, finely granular chromatin, inconspicuous nucleoli, scanty cytoplasm, and indistinct cell margins. Original magnification: 1000X, oil immersion.
Image by euthman
Treatment of Recurrent Small Cell Lung Cancer
Treatment of recurrent small cell lung cancer may include the following:
Chemotherapy.
Immunotherapy with immune checkpoint inhibitors.
Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
Laser therapy, stent placement to keep airways open, and/or internal radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
Clinical trials of new chemotherapy treatments.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Source: National Cancer Institute (NCI)
Additional Materials (1)
Will Lung Cancer Come Back?
Video by HenryFordTV/YouTube
1:08
Will Lung Cancer Come Back?
HenryFordTV/YouTube
Limited-Stage Small Cell Lung Cancer
Diagram showing how you have internal radiotherapy for lung cancer
Image by Cancer Research UK/Wikimedia
Diagram showing how you have internal radiotherapy for lung cancer
Diagram showing how you have internal radiotherapy for lung cancer.
Image by Cancer Research UK/Wikimedia
Treatment of Limited-Stage Small Cell Lung Cancer
Treatment of limited-stage small cell lung cancer may include the following:
Combination chemotherapy and radiation therapy to the chest. Radiation therapy to the brain may later be given to patients with complete responses.
Combination chemotherapy alone for patients who cannot be given radiation therapy.
Surgery followed by chemotherapy.
Surgery followed by chemotherapy and radiation therapy.
Radiation therapy to the brain may be given to patients who have had a complete response, to prevent the spread of cancer to the brain.
Clinical trials of new chemotherapy, surgery, and radiation treatments.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Source: National Cancer Institute (NCI)
Additional Materials (5)
Sensitive content
This media may include sensitive content
Migrating Lung Cancer Cells
A differential interference contrast image illustrating the aggressive shape of live, migrating non-small cell lung cancer cells. Therapies that are able to stop the migration of tumor cells can help stem or prevent the spread of cancer (metastasis).
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Univ. of Pittsburgh Cancer Center / Wei Qian
Prognosis for Small Cell Lung Cancer
Micrograph of squamous carcinoma, also squamous cell carcinoma.
Image by Nephron
Sensitive content
This media may include sensitive content
Lung Cancer Autophagy
Autophagy represents a cell's response to chemotherapy and radiation that may be one component of resistance to therapy. H460 non-small cell lung cancer cells were exposed to the antitumor drug, etoposide. The image shows the H460 cells (in green) containing acidic autophagic vauoles (orange) that are extranuclear. The small bright green bodies are likely to be micronuclei.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project and selected for exhibit. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Massey Cancer Center at Virginia Commonwealth Univ. / David A. Gewirtz and Tareq Saleh
Sensitive content
This media may include sensitive content
Non-Small Lung Cancer After Etoposide Treatment
H460 non-small cell lung cancer cells were exposed to the antitumor drug, etoposide. The image shows the H460 cells (in green) containing orange (acidic) autophagic vauoles that are extranuclear. The small bright green bodies are likely to be micronuclei. Autophagy represents a response to chemotherapy and radiation that may be one component of resistance to therapy.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Massey Cancer Center at Virginia Commonwealth Univ. / David A. Gewirtz, Tareq Saleh
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Non-Small Lung Cancer After Cisplatin Treatment
H460 non-small cell lung cancer cells were exposed to the antitumor drug, cisplatin after autophagy inhibition. The image shows the H460 cells (in green) showing changed staining intensity after inhibition of autophagy. The small bright green bodies are likely to be micronuclei. Autophagy represents a response to chemotherapy and radiation that may be one component of resistance to therapy.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
See also https://visualsonline.cancer.gov/closeup2016.
Image by National Cancer Institute \ Massey Cancer Center at Virginia Commonwealth Univ. / David A. Gewirtz, Tareq Saleh
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Migrating Lung Cancer Cells
National Cancer Institute \ Univ. of Pittsburgh Cancer Center / Wei Qian
Prognosis for Small Cell Lung Cancer
Nephron
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Lung Cancer Autophagy
National Cancer Institute \ Massey Cancer Center at Virginia Commonwealth Univ. / David A. Gewirtz and Tareq Saleh
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Non-Small Lung Cancer After Etoposide Treatment
National Cancer Institute \ Massey Cancer Center at Virginia Commonwealth Univ. / David A. Gewirtz, Tareq Saleh
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Non-Small Lung Cancer After Cisplatin Treatment
National Cancer Institute \ Massey Cancer Center at Virginia Commonwealth Univ. / David A. Gewirtz, Tareq Saleh
Prognosis
Grading Cancer
Image by TheVisualMD
Grading Cancer
Another technique that aids doctors in planning treatment and estimating prognosis for the disease is called tumor grading. Tumor grading is a system in which cancer cells are classified according to how abnormal their appearance is under a microscope and how quickly the tumor is likely to grow and spread. Histologic grade (differentiation) refers to how much the tumor cells resemble normal cells of the same tissue type.
Nuclear grade refers to the size and shape of the nucleus in tumor cells and the percentage of tumor cells that are dividing.
Image by TheVisualMD
Prognosis of Small Cell Lung Cancer
Prognosis
The prognosis (chance of recovery) and treatment options depend on the following:
The stage of the cancer (whether it is in the chest cavity only or has spread to other places in the body).
The patient’s age, gender, and general health.
For certain patients, prognosis also depends on whether the patient is treated with both chemotherapy and radiation.
For most patients with small cell lung cancer, current treatments do not cure the cancer.
If lung cancer is found, patients should think about taking part in one of the many clinical trials being done to improve treatment. Clinical trials are taking place in most parts of the country for patients with all stages of small cell lung cancer.
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Small Cell Lung Cancer
Small cell lung cancer is an aggressive cancer that forms in tissues of the lung and can spread to other parts of the body. Smoking is the major risk factor for development of this disease. Learn more about symptoms, diagnostic tests, and treatment options.