Tissue Acquisition in Patients with Suspected Lung Cancer: Techniques Available to the Pulmonologist

Abstract

The method of diagnosis and staging of lung cancer for the most part depends on the type of lung cancer, small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC), the size and location of the primary tumor, the stage, and the overall clinical status of the patient. Although it is reassuring that the accuracy of differentiating between SCLC and NSCLC generated by various diagnostic techniques is excellent (Rivera et al. Chest 143(5 Suppl):e142S, 2013), treatment of NSCLC now relies on accurate histopathologic diagnosis and molecular characterization of the tumor. In recent years, we have witnessed a revolution in our understanding of the molecular genotype of lung cancer, and certain molecular determinants not only guide treatment decision-making but also have a prognostic and predictive function. Clinicians who perform diagnostic procedures in lung cancer need to be familiar with the array of options for tissue acquisition as well as the importance of judicious handling of specimens in order to derive the most information from each procedure.