Bronchial Adenoma (cont.)
Exams and Tests
- Chest x-ray films may demonstrate a nodule (less than 3 cm in diameter) or a larger mass of tumor. Oblique-view chest x-ray films may improve the ability to detect central lesions on chest x-ray films.
- Computed tomography (CT) scan of the chest allows a better assessment of the tumor. The doctor can tell how big the tumor is, exactly where it is located in the lung, and whether it looks like it is spreading to the lymph nodes.
- Magnetic resonance imaging (MRI) is generally used when CT scan findings are unclear.
None of the above techniques accurately differentiate bronchial adenoma from other neoplasms (growths).
- Octreotide nuclear scan is a test used to detect carcinoid tumors and to determine sites to which they have spread.
- Bronchoscopy: This procedure is used to visualize the inside of the trachea (windpipe) and large airways in the lung for abnormal growths. After giving the person a sedative, the doctor numbs the throat and windpipe with local anesthesia. A bronchoscope (a thin, flexible, lighted tube with a tiny camera at the end) is inserted through the mouth or nose and then down the windpipe. From there, the bronchoscope can be used to look at the airways (bronchi) of the lungs. During bronchoscopy, the doctor may perform a biopsy (a sample of cells removed for examination under a microscope) on the tumor.
- Transbronchoscopic fine-needle aspiration: If the lesion is not easily accessible on the airway wall or is less than 2 cm in diameter, a fine-needle aspiration biopsy may be performed as a part of the bronchoscopic examination.
- CT-guided fine-needle aspiration: If a peripheral nodule is present, a needle may be inserted through the chest wall, between the ribs, and placed in the nodule. This biopsy specimen can be examined under the microscope to determine if the nodule is benign (noncancerous) or malignant.
If these tests are nondiagnostic and if malignancy is likely, a thoracoscopic procedure or an open thoracotomy
(incision through the chest wall) may be performed.
Charles W Van Way III, MD
Koyamangalath Krishnan, MD, FRCP
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